Healthcare Provider Details

I. General information

NPI: 1770816290
Provider Name (Legal Business Name): MIRACLE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8660 W FLAGLER ST STE 214
MIAMI FL
33144-2061
US

IV. Provider business mailing address

8660 W FLAGLER ST STE 214
MIAMI FL
33144-2061
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-1945
  • Fax: 305-266-1947
Mailing address:
  • Phone: 305-266-1945
  • Fax: 305-266-1947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIZI ROCHE
Title or Position: PRESIDENT
Credential:
Phone: 305-266-1945