Provider Demographics
NPI:1184335069
Name:REWIRED THERAPY LLC
Entity type:Organization
Organization Name:REWIRED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-676-6070
Mailing Address - Street 1:2820 NE 214TH ST STE 1002
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1270
Mailing Address - Country:US
Mailing Address - Phone:305-626-6070
Mailing Address - Fax:
Practice Address - Street 1:12550 BISCAYNE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2537
Practice Address - Country:US
Practice Address - Phone:305-397-8623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty