=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396553251
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BP BUILDERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2024
-----------------------------------------------------
Last Update Date | 12/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 340 AMELIA CT
-----------------------------------------------------
City | ST AUGUSTINE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32080-7658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-502-2610
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 270
-----------------------------------------------------
City | ST AUGUSTINE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32085-0270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-502-2610
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | BARTLOMIEJ DANIAL PINIAZ
-----------------------------------------------------
Credential | CBC
-----------------------------------------------------
Telephone | 904-502-2610
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171WH0202X
-----------------------------------------------------
Taxonomy Name | Home Modifications Contractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------