Provider Demographics
NPI:1659681047
Name:SMILING TO YOURS LIFE 1 CORP
Entity Type:Organization
Organization Name:SMILING TO YOURS LIFE 1 CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:305-559-6336
Mailing Address - Street 1:2711 SW 137TH AVE STE 77
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6360
Mailing Address - Country:US
Mailing Address - Phone:305-559-6336
Mailing Address - Fax:305-559-6316
Practice Address - Street 1:2711 SW 137TH AVE STE 77
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6360
Practice Address - Country:US
Practice Address - Phone:305-559-6336
Practice Address - Fax:305-559-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy