Provider Demographics
NPI:1124532957
Name:OASIS SPECIALIZED THERAPY CARE
Entity type:Organization
Organization Name:OASIS SPECIALIZED THERAPY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EZEQUIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-417-1191
Mailing Address - Street 1:15485 EAGLE NEST LN STE 120
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2221
Mailing Address - Country:US
Mailing Address - Phone:305-417-0158
Mailing Address - Fax:305-602-8929
Practice Address - Street 1:15485 EAGLE NEST LN STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2221
Practice Address - Country:US
Practice Address - Phone:305-417-0158
Practice Address - Fax:305-602-8929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty