Provider Demographics
NPI:1811606213
Name:ELITE THERAPY SERVICE INC
Entity type:Organization
Organization Name:ELITE THERAPY SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-755-2852
Mailing Address - Street 1:815 NW 57TH AVE STE 200-14
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2018
Mailing Address - Country:US
Mailing Address - Phone:786-755-2852
Mailing Address - Fax:813-582-7170
Practice Address - Street 1:815 NW 57TH AVE STE 200-14
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2018
Practice Address - Country:US
Practice Address - Phone:786-755-2852
Practice Address - Fax:813-582-7170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health