MEDICARE: BSM SERVICES, CORP

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
1	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1487329538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BSM SERVICES, CORP

Provider Business Mailing Address
First Line	:	3930 NW 7TH ST APT 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3930 NW 7TH ST APT 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5564
Country	:	US
Telephone Number	:	786-209-6049
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SUYAPA RIVERA
Credential	:
Telephone Number	:	786-209-6049

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	08/11/2021

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