Organization
EARLY NAVIGATORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA VANDERMYDE DPT (PHYSICAL THERAPIST)
(305) 546-5604
Entity
Organization
Contact information
Practice address
13747 SW 31ST TER, MIAMI, FL 33175-8804
(305) 546-5604
Mailing address
13747 SW 31ST TER, MIAMI, FL 33175-8804
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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