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General NPI Number Information
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NPI Number | 1952539199
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Entity Type | Organization
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Legal Business Name | BLESS THE LORD INC
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 2331 JAMAICA DR
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City | MIRAMAR
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State | FL
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Zip | 33023-3550
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Country | US
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Telephone | 954-549-8861
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Fax | 954-981-3216
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Provider Business Mailing Address
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Address Line | 2331 JAMAICA DR
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City | MIRAMAR
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State | FL
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Zip | 33023-3550
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Country | US
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Telephone | 954-981-3216
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Fax | 954-981-3216
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Authorized Official
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Title or Position | CARE PROVIDER
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Name | MS. GLADYS COICOU
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Credential |
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Telephone | 954-549-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number | C200280638400
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License Number State | FL
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