Provider Demographics
NPI:1588125744
Name:BIO-MEDICAL REHABILITATION AND WELLNESS
Entity type:Organization
Organization Name:BIO-MEDICAL REHABILITATION AND WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURICI
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:305-205-6161
Mailing Address - Street 1:9905 NW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2405
Mailing Address - Country:US
Mailing Address - Phone:305-205-6161
Mailing Address - Fax:
Practice Address - Street 1:9905 NW 79TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-2405
Practice Address - Country:US
Practice Address - Phone:305-205-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy