Dynamic Therapy Institute Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

MH5842 Issued in FL

Legal business name

DYNAMIC THERAPY INSTITUTE INC.

Practice address

4471 NW 36TH St Ste 214
Miami Springs, FL 33166-7288

Phone

(786) 317-2526

NPI assigned

Jul 11, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kenny Goodrich

Title

Ceo

Phone

(786) 317-2526

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1316399751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4471 NW 36TH ST STE 214",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667288",
            "telephone_number": "786-317-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4471 NW 36TH ST STE 214",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667288",
            "telephone_number": "786-317-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC THERAPY INSTITUTE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "GOODRICH",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-317-2526",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "MH5842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Miami Springs, FL
• Providers in Miami Springs, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.