Provider Demographics
NPI:1730471160
Name:C&B PROHANDS CARE
Entity Type:Organization
Organization Name:C&B PROHANDS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-380-0929
Mailing Address - Street 1:PO BOX 350531
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-0531
Mailing Address - Country:US
Mailing Address - Phone:786-380-0929
Mailing Address - Fax:305-642-8505
Practice Address - Street 1:1838 NW FLAGLER TER APT 7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5425
Practice Address - Country:US
Practice Address - Phone:786-380-0929
Practice Address - Fax:305-642-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA62200225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty