THERAPY SPORT MEDICAL CORP
Osteopathic Medicine at 36 St, Miami, FL

License number
Florida HCC9145
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: HISELA M CASTRO
Title: PRESIDENT
Phone: (305) 526-8229
Address
Address
6555 NW 36Th St SUITE 214, Miami, FL 33166
National Provider ID: 1023392297
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THERAPY SPORT MEDICAL CORP

Miami, FL

Status:
Inactive
Inactive reason:
VOLUNTARY DISSOLUTION
Registration:
Apr 12, 2011
Inactive since:
Sep 11, 2014
Addresses:
6555 NW 36 St SUITE 214, Miami, FL 33166 (Physical)
Miami, FL 33283 (Mailing)
PO Box 832711, Miami, FL 33283
State ID:
P11000035899
Business type:
Florida Profit Corporation
President, Principal:
Hisela M Castro President, Principal, inactive, 6555 NW 36 St SUITE 214, Miami, FL 33166 (Physical)
Agent:
Hisela Castro,6555 NW 36 St SUITE 214, Miami, FL 33166 (Physical)
EIN:
45-1643102

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