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General NPI Number Information
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NPI Number | 1548566946
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Entity Type | Organization
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Legal Business Name | NEW BEGINNING THERAPEUTIC INC
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 1140 W 50TH ST STE 200A
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City | HIALEAH
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State | FL
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Zip | 33012-3438
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Country | US
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Telephone | 305-818-2444
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Fax | 305-825-5200
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Provider Business Mailing Address
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Address Line | 1140 W 50TH ST STE 200A
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City | HIALEAH
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State | FL
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Zip | 33012-3438
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Country | US
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Telephone | 305-818-2444
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Fax | 305-825-5200
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDRES POLANCO
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Credential | LMT
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Telephone | 305-818-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61108
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License Number State | FL
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