Healthcare Provider Details

I. General information

NPI: 1396760971
Provider Name (Legal Business Name): BWTII INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 CORPOREX PARK DR STE 105B
TAMPA FL
33619-1160
US

IV. Provider business mailing address

3333 S CONGRESS AVE STE 100
DELRAY BEACH FL
33445-7300
US

V. Phone/Fax

Practice location:
  • Phone: 813-985-8800
  • Fax: 561-450-1443
Mailing address:
  • Phone: 561-274-4149
  • Fax: 727-799-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA20360096
License Number StateFL

VIII. Authorized Official

Name: KIMBERLY MICHELLE HUNTER
Title or Position: DIRECTOR OF CONTRACT DEVELOPMENT
Credential:
Phone: 727-888-2844