Provider Demographics
NPI:1902066095
Name:MIDAS TOUCH INSTITUTE FOR PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:MIDAS TOUCH INSTITUTE FOR PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MENDIETA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:305-740-7292
Mailing Address - Street 1:7800 SW 57TH AVE
Mailing Address - Street 2:300
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5528
Mailing Address - Country:US
Mailing Address - Phone:305-740-7292
Mailing Address - Fax:305-476-8320
Practice Address - Street 1:7800 SW 57TH AVE
Practice Address - Street 2:300
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-740-7292
Practice Address - Fax:305-476-8320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6315225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885450500Medicaid
FL885450500Medicaid