Provider Demographics
NPI:1114216470
Name:PACE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:PACE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:JULIA L
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:786-514-6316
Mailing Address - Street 1:2510 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-3821
Mailing Address - Country:US
Mailing Address - Phone:786-514-6316
Mailing Address - Fax:786-221-4970
Practice Address - Street 1:3306 PONCE DE LEON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7286
Practice Address - Country:US
Practice Address - Phone:786-514-6316
Practice Address - Fax:786-221-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16930261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy