Organization
MAXWELLNESS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEAN PASCAL PRADEL PT (PHYSICAL THERAPY DIRECTOR)
(954) 558-3462
Entity
Organization
Contact information
Practice address
18600 NW 87TH AVE UNIT 126, HIALEAH, FL 33015-3536
(954) 869-4310
(954) 869-4313
Mailing address
18600 NW 87TH AVE UNIT 126, HIALEAH, FL 33015-3536
(954) 869-4310
(954) 869-4313
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT20304
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890766800
—
FL
01
—
PT20304
MEDICAL LICENSE
FL
Enumeration date
01/20/2015
Last updated
07/20/2020
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