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General NPI Number Information
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NPI Number | 1114399359
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Entity Type | Organization
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Legal Business Name | THE GYMNASTICS ACADEMY, CO.
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 15660 SW 72ND ST
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City | MIAMI
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State | FL
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Zip | 33193-1923
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Country | US
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Telephone | 305-386-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 15660 SW 72ND ST
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City | MIAMI
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State | FL
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Zip | 33193-1923
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Country | US
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Telephone | 305-386-8500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VARINIA OLIVEIRA
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Credential |
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Telephone | 786-291-2028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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