Healthcare Provider Details

I. General information

NPI: 1447874433
Provider Name (Legal Business Name): TOTAL BODY HEALTHCARE , INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1558 NE 162ND ST STE A
NORTH MIAMI BEACH FL
33162-4716
US

IV. Provider business mailing address

1558 NE 162ND ST STE A
NORTH MIAMI BEACH FL
33162-4716
US

V. Phone/Fax

Practice location:
  • Phone: 786-245-7444
  • Fax: 786-863-8005
Mailing address:
  • Phone: 786-245-7444
  • Fax: 786-863-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAREN CASTRO
Title or Position: MANAGER
Credential:
Phone: 786-245-7444