Provider Demographics
NPI:1376036046
Name:MINSU'S HEALING OASIS LLC
Entity Type:Organization
Organization Name:MINSU'S HEALING OASIS LLC
Other - Org Name:MINSU HEALING OASIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MINSU
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:305-389-1768
Mailing Address - Street 1:12595 SW 137TH AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4222
Mailing Address - Country:US
Mailing Address - Phone:305-389-1768
Mailing Address - Fax:
Practice Address - Street 1:12595 SW 137TH AVE STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4222
Practice Address - Country:US
Practice Address - Phone:305-389-1768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19563261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy