Organization
PHYSICAL & SPORTS THERAPY CENTER, INC
Active
Other names
Physical & Sports Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKE ADAMEDES PT (PHYSICAL THERAPIST)
(305) 824-9292
Entity
Organization
Contact information
Practice address
7480 FAIRWAY DR, SUITE 204, MIAMI LAKES, FL 33014-6879
(305) 824-9292
(305) 824-0033
Mailing address
7480 FAIRWAY DR, SUITE 204, MIAMI LAKES, FL 33014-6879
(305) 824-9292
(305) 824-0033
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
PT2508
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y915N
BLUECROSS BLUESHIELD
FL
Enumeration date
05/18/2007
Last updated
02/02/2011
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