Provider Demographics
NPI:1477635456
Name:B & V THERA PRO ASSOCIATES CORP
Entity Type:Organization
Organization Name:B & V THERA PRO ASSOCIATES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:DEL RIESGO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:305-385-0168
Mailing Address - Street 1:14291 SW 120TH ST
Mailing Address - Street 2:SUITE #103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7286
Mailing Address - Country:US
Mailing Address - Phone:305-385-0168
Mailing Address - Fax:305-385-0182
Practice Address - Street 1:14291 SW 120TH ST
Practice Address - Street 2:SUITE #103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7286
Practice Address - Country:US
Practice Address - Phone:305-385-0168
Practice Address - Fax:305-385-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887902801Medicaid
FL887902800Medicaid
FL887902802Medicaid
FLK6123Medicare PIN