Provider Demographics
NPI: | 1932397262 |
---|---|
Name: | BREWSTER GROUP INC |
Entity Type: | Organization |
Organization Name: | BREWSTER GROUP INC |
Other - Org Name: | MGN HEALTHCARE SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | ROXANA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PEREZ ARIAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 305-770-4650 |
Mailing Address - Street 1: | 6175 NW 153RD ST |
Mailing Address - Street 2: | SUITE 328 |
Mailing Address - City: | MIAMI LAKES |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33014-2435 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-770-4650 |
Mailing Address - Fax: | 305-770-4697 |
Practice Address - Street 1: | 6175 NW 153RD ST |
Practice Address - Street 2: | SUITE 328 |
Practice Address - City: | MIAMI LAKES |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33014-2435 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-770-4650 |
Practice Address - Fax: | 305-770-4697 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-10-11 |
Last Update Date: | 2017-02-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 299991899 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |