Provider Demographics
NPI:1215184312
Name:FELICIE INDUSTRIES
Entity Type:Organization
Organization Name:FELICIE INDUSTRIES
Other - Org Name:BODY SOLUTIONS, FITNESS AND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FELICIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-438-3400
Mailing Address - Street 1:5830 E NAPLES PLZ
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5039
Mailing Address - Country:US
Mailing Address - Phone:562-438-3400
Mailing Address - Fax:562-438-3441
Practice Address - Street 1:5830 E NAPLES PLZ
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5039
Practice Address - Country:US
Practice Address - Phone:562-438-3400
Practice Address - Fax:562-438-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT254302251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT25430OtherMEDICARE IDENTIFICATION NUMBER
CAAW881AMedicare PIN