Healthcare Provider Details

I. General information

NPI: 1053159202
Provider Name (Legal Business Name): BODIES ON THE MOVE FITNESS AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 W 84TH ST STE 17
HIALEAH FL
33016-1857
US

IV. Provider business mailing address

730 NE 3RD AVE APT 7
FORT LAUDERDALE FL
33304-2669
US

V. Phone/Fax

Practice location:
  • Phone: 786-550-1099
  • Fax:
Mailing address:
  • Phone: 954-646-6363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. NATHANIEL BELLIOT
Title or Position: MGR
Credential: PTA
Phone: 954-646-6363