Provider Demographics
NPI:1063004042
Name:PHYSIO2RESTORE, CORP.
Entity Type:Organization
Organization Name:PHYSIO2RESTORE, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOSLEIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ - BARZAGA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:786-541-7848
Mailing Address - Street 1:11430 N KENDALL DR STE 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1041
Mailing Address - Country:US
Mailing Address - Phone:786-541-7848
Mailing Address - Fax:
Practice Address - Street 1:11430 N KENDALL DR STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1041
Practice Address - Country:US
Practice Address - Phone:786-541-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No253Z00000XAgenciesIn Home Supportive Care