PREMIER ATHLETIC REHAB CENTER LLC (NPI# 1194082909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194082909 |
| Entity Type | Organization |
| Organization Name | PREMIER ATHLETIC REHAB CENTER LLC |
| Practice Address |
3121 Ponce De Leon Blvd Coral Gables FL 33134-6816 |
| Mailing Address |
Po Box 450844 Miami FL 33245-0844 |
| Practice Telephone | 3053969002 |
| Practice Fax Number | 3053903003 |
| Mailing Telephone | 3053969002 |
| Mailing Fax Number | 3053903003 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2013-11-19 |
| Authorized Official Name | ALEJANDRO G GONZALEZ (PHYSICAL THERAPIST) |
| Authorized Official Telephone | 3052827252 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT25977 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | Y07QR | 01 |
| FL | CIGNA | 2801168 | 01 |
| Street Address |
3121 PONCE DE LEON BLVD |
| City | CORAL GABLES |
| State | FL |
| Zip Code | 33134-6816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417146176 | Eduardo Rodriguez | Physical Therapist | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2007-10-18 |
| 1578061172 | Health and Wellness Physical Therapy Inc. | Clinic/Center | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2018-01-29 |
| 1487048088 | Manuel A Llano | Occupational Therapy Assistant | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2015-03-23 |
| 1700283033 | Mitchell Garcia | Physical Therapist | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2014-12-02 |
| 1558637280 | Arturo Azito Chiropractic Inc | Chiropractor | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2012-03-27 |
| 1154612364 | Gables Injury & Sports Therapy Center LLC | Clinic/Center | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2011-04-21 |
| 1366776510 | Sobe Well, P.a. | Chiropractor | 3121 Ponce De Leon Blvd, Coral Gables, FL 33134-6816 | 2009-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477179794 | Aubree Udell | Behavior Technician | 1500 Douglas Rd., Suite 230, Coral Gables, FL 33134 | 2020-06-23 |
| 1346880481 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 1906 Ponce De Leon Boulvard, Coral Gables, FL 33134 | 2020-01-07 |
| 1306494406 | Giselle Gutierrez | Dermatology | 401 Coral Way, Suite 207, 401 Coral Way Suite 207, Coral Gables, FL 33134 | 2019-09-01 |
| 1376190363 | Jessica Fishel | Behavior Technician | 1500 Douglas Rd., Suite 230, Coral Gables, FL 33134 | 2019-08-23 |
| 1962057380 | Ariel Betancourt | Behavior Technician | 3905 West Flagler St, Apt# 6, Miami, FL 33134 | 2019-08-02 |
| 1023662574 | April Gonzalez | Physical Therapy Assistant | 1500 Dougla Rd, Coral Gables, FL 33134 | 2019-08-01 |
| 1255999678 | Arturo Corces Md Pa | Orthopaedic Surgery | 747 Ponce Deleon Blvd, Ste 505, Coral Gables, FL 33134 | 2019-05-31 |
| 1386200673 | Life Bridge Community Center | Case Management | 5246 Sw 8th St Ste 205c, Miami, FL 33134 | 2019-05-13 |
| 1083187884 | Sun Health Care Inc | Clinic/Center | 3990 West Flagler Street, Suite 406, Miami, FL 33134 | 2019-01-04 |
| 1902389471 | Jamie Lynn Innis | Physician Assistant | 314 Romano Ave, Coral Gables, FL 33134 | 2018-09-11 |
| Find all providers in zip 33134 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467060939 | Coral Gables Physical Therapy, L.L.C. | Clinic/Center | 4200 Laguna St, Coral Gables, FL 33146-1801 | 2020-07-21 |
| 1558984187 | Magic Touch Healing Center, LLC | Clinic/Center | 2828 Sw 22nd St Ste 104, Coral Gables, FL 33145-3214 | 2020-05-18 |
| 1013540905 | Medical Comfort Inc | Clinic/Center | 4800 W Flagler St Ste 211, Coral Gables, FL 33134-1401 | 2020-02-19 |
| 1073079976 | Magic Healing Inc | Clinic/Center | 3990 W Flagler St Ste 100, Coral Gables, FL 33134-1648 | 2019-02-15 |
| 1881115731 | Pure Physical Therapy LLC | Clinic/Center | 22 Merrick Way, Coral Gables, FL 33134-5307 | 2017-06-30 |
| 1255884284 | Parisa Daee Mpt LLC | Clinic/Center | 1450 Madruga Ave Ste 206, Coral Gables, FL 33146-3163 | 2016-07-26 |
| 1285919340 | F.a. Neuromuscular Care Corp | Clinic/Center | 4350 Sw 11th St, Coral Gables, FL 33134-2709 | 2011-10-19 |
| 1851687800 | Luis Gonzalez | Clinic/Center | 145 Madeira Ave Ste 202, Coral Gables, FL 33134-4520 | 2011-06-28 |
| 1114216470 | Pace Physical Therapy Inc | Clinic/Center | 3306 Ponce De Leon Blvd Ste 200, Coral Gables, FL 33134-7286 | 2011-04-06 |
| 1750320156 | Rehabilitation Center of Miami LLC | Clinic/Center | 420 S Dixie Hwy Ste 4d, Coral Gables, FL 33146-2232 | 2006-06-05 |
| Find all providers in CORAL GABLES | ||||
| City | CORAL GABLES |
| Zip Code | 33134 |
Please comment or provide details below to improve the information on PREMIER ATHLETIC REHAB CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.