Provider Demographics
NPI:1164794392
Name:COMPLETE BODY THERAPY INC
Entity Type:Organization
Organization Name:COMPLETE BODY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-494-8737
Mailing Address - Street 1:1830 NW 7TH ST
Mailing Address - Street 2:SUITE 224A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3569
Mailing Address - Country:US
Mailing Address - Phone:305-494-8737
Mailing Address - Fax:
Practice Address - Street 1:1830 NW 7TH ST
Practice Address - Street 2:SUITE 224A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3569
Practice Address - Country:US
Practice Address - Phone:305-494-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy