Healthcare Provider Details

I. General information

NPI: 1063849099
Provider Name (Legal Business Name): HEALINGHANDSCONNECTION.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SW 27TH AVE SUITE 301
MIAMI FL
33135-2961
US

IV. Provider business mailing address

330 SW 27TH AVE SUITE 301
MIAMI FL
33135-2961
US

V. Phone/Fax

Practice location:
  • Phone: 305-643-9157
  • Fax: 305-642-7557
Mailing address:
  • Phone: 305-643-9157
  • Fax: 305-642-7557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 64482
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME 64482
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 46170
License Number StateFL

VIII. Authorized Official

Name: MR. PEDRO ENRIQUE DIAZ
Title or Position: PRESIDENT/OWNER
Credential: LMT
Phone: 786-419-3480