Provider Demographics
NPI:1164717856
Name:MIRACLES IN MOTION
Entity Type:Organization
Organization Name:MIRACLES IN MOTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUWANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-965-6406
Mailing Address - Street 1:2118 E BUSCH BLOUVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612
Mailing Address - Country:US
Mailing Address - Phone:813-965-6406
Mailing Address - Fax:
Practice Address - Street 1:2118 E BUSCH BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-965-6406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL002672100251E00000X
FL692792196253Z00000X
FL692792198253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1881873354Medicaid