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General NPI Number Information
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NPI Number | 1447945993
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Entity Type | Organization
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Legal Business Name | BREEZY IV HYDRATION THERAPY LLC
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 767 S STATE ROAD 7
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City | PLANTATION
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State | FL
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Zip | 33317-4000
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Country | US
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Telephone | 305-962-8854
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Fax |
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Provider Business Mailing Address
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Address Line | 1602 SW 159TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-2342
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Country | US
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Telephone | 305-962-8854
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. DAPHNE DESMARATTES
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Credential |
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Telephone | 305-962-8854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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