Healthcare Provider Details

I. General information

NPI: 1437705258
Provider Name (Legal Business Name): ELITE THERAPY SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 NW 57TH AVE STE 200-14
MIAMI FL
33126-2018
US

IV. Provider business mailing address

3731 SW 136TH AVE
MIAMI FL
33175-7251
US

V. Phone/Fax

Practice location:
  • Phone: 305-832-9079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO R SUAREZ
Title or Position: OWNER
Credential:
Phone: 786-234-5723