Healthcare Provider Details

I. General information

NPI: 1467540609
Provider Name (Legal Business Name): OCAS THERAPY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6595 NW 36TH ST SUITE 206
VIRGINIA GARDENS FL
33166-6979
US

IV. Provider business mailing address

6595 NW 36TH ST SUITE 206
VIRGINIA GARDENS FL
33166-6979
US

V. Phone/Fax

Practice location:
  • Phone: 305-876-0010
  • Fax: 305-876-1770
Mailing address:
  • Phone: 305-876-0010
  • Fax: 305-876-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME41647
License Number StateFL

VIII. Authorized Official

Name: ABISAI SALAZAR
Title or Position: OWNER/PRESIDENT
Credential: MA41509
Phone: 305-876-0010