Provider Demographics
NPI:1790012227
Name:A.C PROFESSIONAL THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:A.C PROFESSIONAL THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AGUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DE CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:305-262-5123
Mailing Address - Street 1:85 GRAND CANAL DR
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2561
Mailing Address - Country:US
Mailing Address - Phone:305-262-5123
Mailing Address - Fax:305-262-5131
Practice Address - Street 1:85 GRAND CANAL DR
Practice Address - Street 2:SUITE # 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2561
Practice Address - Country:US
Practice Address - Phone:305-262-5123
Practice Address - Fax:305-262-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty