Provider Demographics
NPI:1821346271
Name:MINT THERAPY CORP.
Entity Type:Organization
Organization Name:MINT THERAPY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-277-8965
Mailing Address - Street 1:13944 SW 8TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3006
Mailing Address - Country:US
Mailing Address - Phone:786-277-8965
Mailing Address - Fax:
Practice Address - Street 1:13944 SW 8TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-3006
Practice Address - Country:US
Practice Address - Phone:786-277-8965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy