Organization
BANYAN PHYSICAL THERAPY
Active
Organization
BANYAN PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO MIRANDA (PHYSICAL THERAPIST)
(561) 317-1872
Entity
Organization
Contact information
Practice address
2324 S CONGRESS AVE STE 1A, PALM SPRINGS, FL 33406-7667
(561) 408-0903
(561) 408-0905
Mailing address
2324 S CONGRESS AVE STE 1A, PALM SPRINGS, FL 33406-7667
(561) 408-0903
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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