Provider Demographics
NPI:1639482417
Name:MEDICAL THERAPEUTIC SERVICES,INC
Entity Type:Organization
Organization Name:MEDICAL THERAPEUTIC SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FLAVIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:305-392-1067
Mailing Address - Street 1:10300 SW 72ND ST STE 325
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3019
Mailing Address - Country:US
Mailing Address - Phone:305-392-1067
Mailing Address - Fax:305-392-1069
Practice Address - Street 1:10300 SW 72ND ST STE 325
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3019
Practice Address - Country:US
Practice Address - Phone:305-392-1067
Practice Address - Fax:305-392-1069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL THEARPEUTIC SERVICES,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA29200261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation