Healthcare Provider Details

I. General information

NPI: 1992093363
Provider Name (Legal Business Name): BMS THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4811 NW 79TH AVE SUITE 3
DORAL FL
33166-5438
US

IV. Provider business mailing address

4811 NORTH WEST 79 AVE SUITE 3
DORAL FL
33166
US

V. Phone/Fax

Practice location:
  • Phone: 305-381-5474
  • Fax: 305-381-5931
Mailing address:
  • Phone: 305-381-5474
  • Fax: 305-381-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMM27224
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MISS MARIA AUXILIADORA CASSAB
Title or Position: PRESIDENT
Credential:
Phone: 305-381-5474