Provider Demographics
NPI:1972034866
Name:A & C PT SERVICES CORP
Entity Type:Organization
Organization Name:A & C PT SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:I
Authorized Official - Last Name:SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:786-718-7028
Mailing Address - Street 1:15416 SW 95TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1145
Mailing Address - Country:US
Mailing Address - Phone:786-294-1384
Mailing Address - Fax:
Practice Address - Street 1:15416 SW 95TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1145
Practice Address - Country:US
Practice Address - Phone:786-294-1384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA24451261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy