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NPI Code Detail

MEDICARE: BLUE D CLASS MEDSPA & THERAPY INC

MEDICARE: BLUE D CLASS MEDSPA & THERAPY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center
2261QP2000XPhysical Therapy Clinic/Center
3207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1417721325
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE D CLASS MEDSPA & THERAPY INC
Provider Business Mailing Address
First Line : 3009 NW 7 STREET
Second Line :
City : MIAMI
State : FL
Zip : 33125-4203
Country : US
Telephone Number : 786-963-5892
Fax Number : 305-489-6456
Provider Business Practice Location Address
First Line : 3009 NW 7 STREET
Second Line :
City : MIAMI
State : FL
Zip : 33125-4203
Country : US
Telephone Number : 786-963-5892
Fax Number : 305-489-6456
Authorized Official
Title or Position : PRESIDENT
Name : YOANDRA RODRIGUEZ
Credential :
Telephone Number : 786-963-5892
Provider Enumeration Date : 11/10/2023
Last Update Date : 12/29/2025

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Directions to “BLUE D CLASS MEDSPA & THERAPY INC ” Practice Location

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