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General NPI Number Information
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NPI Number | 1366810079
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Entity Type | Organization
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Legal Business Name | BIG BEAR ACADEMY
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 9035 SUNSET DR STE 100
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City | MIAMI
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State | FL
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Zip | 33173-3441
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Country | US
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Telephone | 786-641-6858
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Fax | 786-523-7567
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Provider Business Mailing Address
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Address Line | 9035 SUNSET DR STE 100
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City | MIAMI
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State | FL
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Zip | 33173-3441
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Country | US
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Telephone | 786-641-6858
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Fax | 786-523-7567
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE C. SUAREZ FERNANDEZ
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Credential |
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Telephone | 786-641-6858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | PP29960085
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License Number State | FL
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