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NPI Code Detail

MEDICARE: CAMP SOBE WELL

MEDICARE: CAMP SOBE WELL
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor
2103T00000XPsychologist
3261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1255703989
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMP SOBE WELL
Provider Business Mailing Address
First Line : 5226 ALTON RD
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-2005
Country : US
Telephone Number : 786-303-6862
Fax Number :
Provider Business Practice Location Address
First Line : 5226 ALTON RD
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-2005
Country : US
Telephone Number : 786-303-6862
Fax Number :
Authorized Official
Title or Position : CEO
Name : PATRECE FRISBEE
Credential :
Telephone Number : 786-303-6862
Provider Enumeration Date : 10/21/2015
Last Update Date : 06/23/2016

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Directions to “CAMP SOBE WELL ” Practice Location

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