Provider Demographics
NPI:1992088850
Name:G.S.B MANAGMENT GROUP
Entity type:Organization
Organization Name:G.S.B MANAGMENT GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCUR
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:305-904-9534
Mailing Address - Street 1:6501 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6959
Mailing Address - Country:US
Mailing Address - Phone:305-904-9534
Mailing Address - Fax:
Practice Address - Street 1:6501 NW 36TH ST STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6961
Practice Address - Country:US
Practice Address - Phone:305-904-9534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation