Provider Demographics
NPI:1215369350
Name:A&W HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:A&W HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:786-457-3049
Mailing Address - Street 1:PO BOX 695419
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33269-5419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18921 NW 2ND AVE
Practice Address - Street 2:STE B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4008
Practice Address - Country:US
Practice Address - Phone:305-816-6627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28103261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy