Provider Demographics
NPI:1215801618
Name:123 THERAPY INC.
Entity type:Organization
Organization Name:123 THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALARICO DE NOLASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-651-9311
Mailing Address - Street 1:14040 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-6809
Mailing Address - Country:US
Mailing Address - Phone:305-651-9311
Mailing Address - Fax:
Practice Address - Street 1:14040 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-6809
Practice Address - Country:US
Practice Address - Phone:305-651-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty