Provider Demographics
NPI:1669209672
Name:BUTTERFLY HOUSE PEDIATRIC THERAPY CENTER LLC
Entity type:Organization
Organization Name:BUTTERFLY HOUSE PEDIATRIC THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OTAMI
Authorized Official - Middle Name:DE LA CARIDAD
Authorized Official - Last Name:LAM RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-253-3746
Mailing Address - Street 1:3450 W 84TH ST STE 202C
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4956
Mailing Address - Country:US
Mailing Address - Phone:786-253-3746
Mailing Address - Fax:
Practice Address - Street 1:3450 W 84TH ST STE 202C
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4956
Practice Address - Country:US
Practice Address - Phone:786-253-3746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center