Provider Demographics
NPI:1316273675
Name:WORK INJURY SOLUTIONS OF DADE COUNTY INC
Entity type:Organization
Organization Name:WORK INJURY SOLUTIONS OF DADE COUNTY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:305-593-1973
Mailing Address - Street 1:7911 NW 72ND AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2227
Mailing Address - Country:US
Mailing Address - Phone:305-888-6959
Mailing Address - Fax:305-887-8180
Practice Address - Street 1:7911 NW 72ND AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-2227
Practice Address - Country:US
Practice Address - Phone:305-888-6959
Practice Address - Fax:305-887-8180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15162261QP2000X
FLME0083304261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy