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General NPI Number Information
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NPI Number | 1811306426
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Entity Type | Organization
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Legal Business Name | SASSON THERAPIST CORP
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 7821 CORAL WAY SUITE # 104
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City | MIAMI
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State | FL
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Zip | 33155-6542
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Country | US
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Telephone | 786-762-7382
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Fax | 786-345-5930
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Provider Business Mailing Address
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Address Line | 7821 CORAL WAY SUITE # 104
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City | MIAMI
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State | FL
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Zip | 33155-6542
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Country | US
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Telephone | 786-762-7382
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Fax | 786-345-5930
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CARLOS ALBERTO BLANCO
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Credential | MD
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Telephone | 786-762-7382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME71266
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License Number State | FL
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