Healthcare Provider Details

I. General information

NPI: 1093246407
Provider Name (Legal Business Name): BODY FLOW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 OLD DIXIE HWY STE 2
HOMESTEAD FL
33033-3212
US

IV. Provider business mailing address

1850 OLD DIXIE HWY STE 2
HOMESTEAD FL
33033-3212
US

V. Phone/Fax

Practice location:
  • Phone: 786-678-4479
  • Fax: 305-508-6712
Mailing address:
  • Phone: 786-678-4479
  • Fax: 305-508-6712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT7749
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberPT7749
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MRS. CLARA ELISA VELOSA
Title or Position: PRESIDENT
Credential: RPT
Phone: 786-678-4479