Provider Demographics
NPI:1073079976
Name:MAGIC HEALING INC
Entity type:Organization
Organization Name:MAGIC HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERO ILANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-397-2617
Mailing Address - Street 1:3990 W FLAGLER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1648
Mailing Address - Country:US
Mailing Address - Phone:305-443-7390
Mailing Address - Fax:
Practice Address - Street 1:3990 W FLAGLER ST STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1648
Practice Address - Country:US
Practice Address - Phone:305-443-7390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy