Organization
MAXWELLNESS PHYSICAL THERAPY LLC
Active
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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