Healthcare Provider Details

I. General information

NPI: 1134423239
Provider Name (Legal Business Name): MY HOPE THERAPEUTIC AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12039 SW 132ND CT 28-1
MIAMI FL
33186-4783
US

IV. Provider business mailing address

12039 SW 132ND CT 28-1
MIAMI FL
33186-4783
US

V. Phone/Fax

Practice location:
  • Phone: 305-251-2411
  • Fax: 305-251-2412
Mailing address:
  • Phone: 305-251-2411
  • Fax: 305-251-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERTO J RIVERA
Title or Position: PRESIDENT
Credential:
Phone: 305-251-2411