Provider Demographics
NPI:1871832576
Name:BUILDING FOUNDATIONS THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:BUILDING FOUNDATIONS THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESA
Authorized Official - Middle Name:LORENA
Authorized Official - Last Name:HEREDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-383-2223
Mailing Address - Street 1:14050 SW 84TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4440
Mailing Address - Country:US
Mailing Address - Phone:305-383-2223
Mailing Address - Fax:305-383-3956
Practice Address - Street 1:14050 SW 84TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4440
Practice Address - Country:US
Practice Address - Phone:305-383-2223
Practice Address - Fax:305-383-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008198200Medicaid