Provider Demographics
NPI:1689877425
Name:ADVANTAGE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:ADVANTAGE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:C
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-225-3044
Mailing Address - Street 1:2500 SW 107TH AVE
Mailing Address - Street 2:SUITE 25
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2470
Mailing Address - Country:US
Mailing Address - Phone:305-225-3044
Mailing Address - Fax:305-225-3045
Practice Address - Street 1:2500 SW 107TH AVE
Practice Address - Street 2:SUITE 25
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2470
Practice Address - Country:US
Practice Address - Phone:305-225-3044
Practice Address - Fax:305-225-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherREHABILITATION FACILITY