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General NPI Number Information
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NPI Number | 1427288851
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Entity Type | Organization
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Legal Business Name | BOLANOS ASSOCIATES, LLC.
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1150 NW 72ND AVE STE 720
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City | MIAMI
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State | FL
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Zip | 33126-1932
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Country | US
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Telephone | 786-259-0300
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Fax | 866-665-8671
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Provider Business Mailing Address
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Address Line | 15751 SHERIDAN ST # 303
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City | FORT LAUDERDALE
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State | FL
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Zip | 33331-3486
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Country | US
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Telephone | 786-259-0300
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Fax | 866-665-8671
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. JEANETTE ROCA
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Credential |
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Telephone | 786-259-0300
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT9463
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | OT9463
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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