Healthcare Provider Details

I. General information

NPI: 1497141170
Provider Name (Legal Business Name): JOSUE THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 W FLAGLER ST STE 111
MIAMI FL
33144-2096
US

IV. Provider business mailing address

8300 W FLAGLER ST STE 111
MIAMI FL
33144-2096
US

V. Phone/Fax

Practice location:
  • Phone: 786-328-8390
  • Fax: 305-328-9306
Mailing address:
  • Phone: 786-328-8390
  • Fax: 305-328-9306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSUE GUERRA
Title or Position: PRSIDENT
Credential:
Phone: 786-328-8390