Provider Demographics
NPI:1518990126
Name:FAST THERAPY CENTER,INC
Entity Type:Organization
Organization Name:FAST THERAPY CENTER,INC
Other - Org Name:FAST THERAPY CENTER, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:305-649-3130
Mailing Address - Street 1:2127 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1618
Mailing Address - Country:US
Mailing Address - Phone:305-649-3130
Mailing Address - Fax:305-649-3109
Practice Address - Street 1:2127 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1618
Practice Address - Country:US
Practice Address - Phone:305-649-3130
Practice Address - Fax:305-649-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686748Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER