Organization
VENGEANCE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS ACOSTA DPT (MANAGING MEMBER)
(786) 399-5515
Entity
Organization
Contact information
Practice address
331 85TH ST APT 24, MIAMI BEACH, FL 33141-4803
(786) 399-5515
Mailing address
331 85TH ST APT 24, MIAMI BEACH, FL 33141-4803
(786) 399-5515
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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