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General NPI Number Information
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NPI Number | 1992088850
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Entity Type | Organization
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Legal Business Name | G.S.B MANAGMENT GROUP
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 6501 NW 36TH ST STE 100
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6961
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Country | US
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Telephone | 305-904-9534
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 NW 36TH ST
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6959
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Country | US
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Telephone | 305-904-9534
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARLOS BETANCUR
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Credential | OWNER
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Telephone | 305-904-9534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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