MEDICARE: SUMMER SOLSTICE 2006 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171100000X	Acupuncturist
2	225100000X	Physical Therapist
3	225X00000X	Occupational Therapist
4	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1023630894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMER SOLSTICE 2006 LLC

Provider Business Mailing Address
First Line	:	333 UNIVERSITY DR APT 401
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-7265
Country	:	US
Telephone Number	:	305-305-0396
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 BRIDGEPORT AVE
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-3607
Country	:	US
Telephone Number	:	305-305-0396
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NORA B FARINAS
Credential	:	LMT
Telephone Number	:	305-305-0396

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	05/14/2020

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