Healthcare Provider Details

I. General information

NPI: 1386453264
Provider Name (Legal Business Name): JEMS THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 NE 163RD ST STE C
N MIAMI BEACH FL
33162-4500
US

IV. Provider business mailing address

1117 NE 163RD ST STE C
N MIAMI BEACH FL
33162-4500
US

V. Phone/Fax

Practice location:
  • Phone: 786-505-1617
  • Fax:
Mailing address:
  • Phone: 786-505-1617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: AVIGAYIL SHAFFREN
Title or Position: REGISTERED AGENT
Credential:
Phone: 786-505-1617