Provider Demographics
NPI:1093012155
Name:BAMM SERVICES GROUP, LLC
Entity Type:Organization
Organization Name:BAMM SERVICES GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-586-1045
Mailing Address - Street 1:6373 SW 165TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4482
Mailing Address - Country:US
Mailing Address - Phone:786-586-1045
Mailing Address - Fax:
Practice Address - Street 1:6373 SW 165TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-4482
Practice Address - Country:US
Practice Address - Phone:786-586-1045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9891251E00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No252Y00000XAgenciesEarly Intervention Provider Agency