Individual
JAVIER BOLANO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14161 SW 176TH TER, MIAMI, FL 33177-7763
(305) 338-4539
Mailing address
14161 SW 176TH TER, MIAMI, FL 33177-7763
(305) 338-4539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
26320
FL
Other
Enumeration date
09/05/2016
Last updated
09/05/2016
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