Provider Demographics
NPI:1437770682
Name:OPTIMAL HUMAN MOVEMENT
Entity Type:Organization
Organization Name:OPTIMAL HUMAN MOVEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-396-9002
Mailing Address - Street 1:4640 SW 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4723
Mailing Address - Country:US
Mailing Address - Phone:301-247-5259
Mailing Address - Fax:
Practice Address - Street 1:2631 SW 27TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2239
Practice Address - Country:US
Practice Address - Phone:305-396-9002
Practice Address - Fax:305-393-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty