Organization
GENOMA MEDICAL & REHABILITATION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYDEL MIRANDA LMT (PRESIDENT/MASSAGE THERAPIST)
(305) 834-5695
Entity
Organization
Contact information
Practice address
6555 NW 36TH ST STE 116117, VIRGINIA GARDENS, FL 33166-6978
(305) 874-2229
(305) 874-2229
Mailing address
6555 NW 36TH ST STE 116117, VIRGINIA GARDENS, FL 33166-6978
(305) 874-2229
(305) 874-2229
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MA 63085
FL
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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