Provider Demographics
NPI:1083313282
Name:SUPERIOR RELIEF THERAPY CORP
Entity Type:Organization
Organization Name:SUPERIOR RELIEF THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:J
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-414-9723
Mailing Address - Street 1:2701 W OAKLAND PARK BLVD STE 414
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1389
Mailing Address - Country:US
Mailing Address - Phone:305-414-9723
Mailing Address - Fax:
Practice Address - Street 1:2701 W OAKLAND PARK BLVD STE 414
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1389
Practice Address - Country:US
Practice Address - Phone:305-414-9723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation