Provider Demographics
NPI:1821735283
Name:SALA, ELIO ALEJANDRO (PTA)
Entity Type:Individual
Prefix:
First Name:ELIO
Middle Name:ALEJANDRO
Last Name:SALA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 SW 72ND ST STE 212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3273
Mailing Address - Country:US
Mailing Address - Phone:786-362-5555
Mailing Address - Fax:786-362-5104
Practice Address - Street 1:9360 SW 72ND ST STE 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3273
Practice Address - Country:US
Practice Address - Phone:786-362-5555
Practice Address - Fax:786-362-5104
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation