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General NPI Number Information
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NPI Number | 1285935825
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Entity Type | Organization
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Legal Business Name | BM&PROFESSIONAL ASSOCIATE,INC
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Dates
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Enumeration Date | 11/13/2010
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Last Update Date | 11/13/2010
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Provider Practice Location Address
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Address Line | 3140 NW 53RD LN
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City | MIAMI
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State | FL
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Zip | 33142-3472
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Country | US
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Telephone | 786-662-9188
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Fax | 786-431-5734
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Provider Business Mailing Address
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Address Line | 3140 NW 53RD LN
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City | MIAMI
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State | FL
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Zip | 33142-3472
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Country | US
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Telephone | 786-662-9188
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Fax | 786-431-5734
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA MEDINA
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Credential | M.S OTR/L
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Telephone | 786-662-9188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 13096
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License Number State | FL
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