Provider Demographics
NPI:1285618751
Name:BWTII INC
Entity type:Organization
Organization Name:BWTII INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-888-2844
Mailing Address - Street 1:3333 S CONGRESS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-7300
Mailing Address - Country:US
Mailing Address - Phone:561-274-4149
Mailing Address - Fax:727-799-1680
Practice Address - Street 1:3710 CORPOREX PARK DR STE 105B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-1160
Practice Address - Country:US
Practice Address - Phone:813-985-8800
Practice Address - Fax:727-799-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20360096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20360096OtherAHCA LICENSE
FL650674700Medicaid