Provider Demographics
NPI:1437327152
Name:I & L THERAPY CENTER CORP
Entity Type:Organization
Organization Name:I & L THERAPY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUILEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-595-0560
Mailing Address - Street 1:10251 SW 72ND ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2957
Mailing Address - Country:US
Mailing Address - Phone:305-595-0560
Mailing Address - Fax:305-595-0310
Practice Address - Street 1:10251 SW 72ND ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2957
Practice Address - Country:US
Practice Address - Phone:305-595-0560
Practice Address - Fax:305-595-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6089261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA452Medicare PIN