Provider Demographics
NPI:1437531530
Name:SCAPE SPA INC
Entity Type:Organization
Organization Name:SCAPE SPA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / VP
Authorized Official - Prefix:
Authorized Official - First Name:EDEL
Authorized Official - Middle Name:JOAO
Authorized Official - Last Name:QUINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-853-7681
Mailing Address - Street 1:13304 SW 128TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5899
Mailing Address - Country:US
Mailing Address - Phone:305-290-6169
Mailing Address - Fax:
Practice Address - Street 1:13304 SW 128TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5899
Practice Address - Country:US
Practice Address - Phone:305-290-6169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM30119225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty