Provider Demographics
NPI:1861848517
Name:PHYSIOWORKS OF MIAMI
Entity Type:Organization
Organization Name:PHYSIOWORKS OF MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-853-6615
Mailing Address - Street 1:3617 E SANDPIPER DR
Mailing Address - Street 2:#5
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-2463
Mailing Address - Country:US
Mailing Address - Phone:561-853-6615
Mailing Address - Fax:305-397-1752
Practice Address - Street 1:3617 E SANDPIPER DR
Practice Address - Street 2:#5
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-2463
Practice Address - Country:US
Practice Address - Phone:561-853-6615
Practice Address - Fax:305-397-1752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT278012251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherBLUE CROSS