MEDICARE: BA GROUP OF MIAMI, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	253Z00000X	In Home Supportive Care Agency
3	305S00000X	Point of Service
4	311Z00000X	Custodial Care Facility
5	315P00000X	Intellectual Disabilities Intermediate Care Facility
6	251C00000X	Developmentally Disabled Services Day Training Agency
7	251E00000X	Home Health Agency
8	174200000X	Meals Provider
9	177F00000X	Lodging Provider
10	320700000X	Physical Disabilities Residential Treatment Facility
11	320800000X	Mental Illness Community Based Residential Treatment Facility
12	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
13	347C00000X	Private Vehicle
14	385H00000X	Respite Care
15	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1215582226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BA GROUP OF MIAMI, LLC

Provider Business Mailing Address
First Line	:	12555 BISCAYNE BLVD # 914
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2522
Country	:	US
Telephone Number	:	786-348-4771
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 NW 108TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33168-6032
Country	:	US
Telephone Number	:	786-348-4771
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHYKIMBERLY QUANTEZ BULLARD
Credential	:	MS
Telephone Number	:	786-348-4771

Provider Enumeration Date	:	08/06/2019
Last Update Date	:	08/06/2019

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Directions to “BA GROUP OF MIAMI, LLC ” Practice Location

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