Provider Demographics
NPI:1659841914
Name:BIOCELLULAR THERAPIES INC
Entity Type:Organization
Organization Name:BIOCELLULAR THERAPIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:EAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-435-1505
Mailing Address - Street 1:2290 W EAU GALLIE BLVD STE 210B
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3145
Mailing Address - Country:US
Mailing Address - Phone:321-435-1505
Mailing Address - Fax:321-253-2700
Practice Address - Street 1:2290 W EAU GALLIE BLVD STE 210B
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3145
Practice Address - Country:US
Practice Address - Phone:321-435-1505
Practice Address - Fax:321-253-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty