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General NPI Number Information
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NPI Number | 1164720454
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Entity Type | Organization
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Legal Business Name | HEALTHY PRACTICE INC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 14003 SW 49TH ST
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City | MIRAMAR
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State | FL
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Zip | 33027-5996
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Country | US
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Telephone | 786-718-5669
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Fax | 305-829-6772
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Provider Business Mailing Address
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Address Line | 14003 SW 49TH ST
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City | MIRAMAR
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State | FL
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Zip | 33027-5996
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Country | US
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Telephone | 786-718-5669
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Fax | 305-829-6772
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIA FERNANDA ISAZA
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Credential | O.T,
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Telephone | 786-718-5669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT10773
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License Number State | FL
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