Healthcare Provider Details

I. General information

NPI: 1124789656
Provider Name (Legal Business Name): MIRACLE WORKERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ANDREWS AVE STE 504
FORT LAUDERDALE FL
33301-2066
US

IV. Provider business mailing address

200 S ANDREWS AVE STE 504
FORT LAUDERDALE FL
33301-2066
US

V. Phone/Fax

Practice location:
  • Phone: 305-497-2738
  • Fax: 754-228-0422
Mailing address:
  • Phone: 305-497-2738
  • Fax: 754-228-0422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: BRIAN BEESING
Title or Position: CEO
Credential:
Phone: 305-497-2738