Healthcare Provider Details

I. General information

NPI: 1003682899
Provider Name (Legal Business Name): RAISE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SW 8TH ST STE 258
MIAMI FL
33144-4000
US

IV. Provider business mailing address

8500 SW 8TH ST STE 258
MIAMI FL
33144-4000
US

V. Phone/Fax

Practice location:
  • Phone: 305-810-8869
  • Fax: 305-402-6468
Mailing address:
  • Phone: 305-810-8869
  • Fax: 305-402-6468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY MIRABAL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 305-810-8869