Provider Demographics
NPI:1699220251
Name:JADE THERAPEUTICS INC
Entity Type:Organization
Organization Name:JADE THERAPEUTICS INC
Other - Org Name:PHYSICAL THERAPY NOW PEMBROKE PINES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAGOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-478-6255
Mailing Address - Street 1:8150 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6710
Mailing Address - Country:US
Mailing Address - Phone:786-295-2241
Mailing Address - Fax:
Practice Address - Street 1:8150 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6710
Practice Address - Country:US
Practice Address - Phone:786-295-2241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty