Provider Demographics
NPI:1912578451
Name:AZUL THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:AZUL THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAITE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORUA-DELGADO RABASSA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:786-409-2646
Mailing Address - Street 1:13500 SW 88TH ST UNIT 285
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1515
Mailing Address - Country:US
Mailing Address - Phone:786-409-2646
Mailing Address - Fax:
Practice Address - Street 1:4236 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7624
Practice Address - Country:US
Practice Address - Phone:786-409-2646
Practice Address - Fax:786-953-6553
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AZUL THERAPY SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-06
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty