Healthcare Provider Details

I. General information

NPI: 1073398871
Provider Name (Legal Business Name): SNAP HUMAN ALIGNMENT OF MIAMI BEACH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6879 COLLINS AVE
MIAMI BEACH FL
33141-3243
US

IV. Provider business mailing address

815 NW 57TH AVE STE 405
MIAMI FL
33126-2054
US

V. Phone/Fax

Practice location:
  • Phone: 305-331-6697
  • Fax: 305-888-5299
Mailing address:
  • Phone: 786-593-3622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: JOSE FERNANDEZ
Title or Position: PURCHASER
Credential:
Phone: 786-593-3622