Provider Demographics
NPI:1093246407
Name:BODY FLOW, INC.
Entity Type:Organization
Organization Name:BODY FLOW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:ELISA
Authorized Official - Last Name:VELOSA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:786-678-4479
Mailing Address - Street 1:1850 OLD DIXIE HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-3212
Mailing Address - Country:US
Mailing Address - Phone:786-678-4479
Mailing Address - Fax:305-508-6712
Practice Address - Street 1:1850 OLD DIXIE HWY STE 2
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3212
Practice Address - Country:US
Practice Address - Phone:786-678-4479
Practice Address - Fax:305-508-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7749261QP2000X, 261QR0400X
261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110773400Medicaid