Organization Name: | BAY AREA NEURO CLINIC INC |
NPI Number: | 1194889709 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSE VICENTE BUSTAMANTE (PRESIDENT) |
Mailing Address: | 6275 E Fowler Ave Temple Terrace |
State: | FL US |
Postal Code: | 33617 |
Phone Number: | 8139853773 |
Fax Number: | 8139847171 |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |