Healthcare Provider Details

I. General information

NPI: 1326073271
Provider Name (Legal Business Name): IVOR SPA & THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SW 87TH AVE
MIAMI FL
33174-3206
US

IV. Provider business mailing address

909 SW 87TH AVE
MIAMI FL
33174-3206
US

V. Phone/Fax

Practice location:
  • Phone: 305-261-8600
  • Fax: 305-261-8600
Mailing address:
  • Phone: 305-261-8600
  • Fax: 305-261-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. GAUDENCIA GOMEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-261-8600