Provider Demographics
NPI:1881721157
Name:FLORIDA OCCUPATIONAL HEALTHCARE
Entity type:Organization
Organization Name:FLORIDA OCCUPATIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHYSIAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREDA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:305-274-3311
Mailing Address - Street 1:7860 SW 129TH TER
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6154
Mailing Address - Country:US
Mailing Address - Phone:305-274-3311
Mailing Address - Fax:305-274-1411
Practice Address - Street 1:9000 SW 87TH CT
Practice Address - Street 2:SUITE 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2231
Practice Address - Country:US
Practice Address - Phone:305-274-3311
Practice Address - Fax:305-274-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16622261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN