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General NPI Number Information
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NPI Number | 1730471160
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Entity Type | Organization
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Legal Business Name | C&B PROHANDS CARE
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 1838 NW FLAGLER TER APT 7
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City | MIAMI
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State | FL
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Zip | 33125-5425
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Country | US
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Telephone | 786-380-0929
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Fax | 305-642-8505
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Provider Business Mailing Address
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Address Line | PO BOX 350531
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City | MIAMI
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State | FL
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Zip | 33135-0531
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Country | US
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Telephone | 786-380-0929
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Fax | 305-642-8505
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. OMAR CRUZ
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Credential | L.M.T
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Telephone | 786-380-0929
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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 | MA62200
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License Number State | FL
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