Provider Demographics
NPI:1891183034
Name:365 HEALTH TECH
Entity Type:Organization
Organization Name:365 HEALTH TECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHAMONDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-389-7850
Mailing Address - Street 1:4471 NW 36TH ST
Mailing Address - Street 2:SUITE# 216-2
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7285
Mailing Address - Country:US
Mailing Address - Phone:305-389-7850
Mailing Address - Fax:305-503-8570
Practice Address - Street 1:4471 NW 36TH ST
Practice Address - Street 2:SUITE# 216-2
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-7285
Practice Address - Country:US
Practice Address - Phone:305-389-7850
Practice Address - Fax:305-503-8570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies