Provider Demographics
NPI:1134580848
Name:FIRST EXCELLENT THERAPY LLC
Entity type:Organization
Organization Name:FIRST EXCELLENT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUENES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-364-5219
Mailing Address - Street 1:175 FONTAINBLEAU BOULEVARD
Mailing Address - Street 2:1-K
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4511
Mailing Address - Country:US
Mailing Address - Phone:305-364-5219
Mailing Address - Fax:305-364-5292
Practice Address - Street 1:175 FONTAINBLEAU BOULEVARD
Practice Address - Street 2:1-K
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172
Practice Address - Country:US
Practice Address - Phone:305-364-5219
Practice Address - Fax:305-364-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center