Active NPI
Celestial Therapy Group Inc
- Family Medicine Physician
- Miami, FL
National Provider Identifier
1629618657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CELESTIAL THERAPY GROUP INC
- Practice address
- 6801 NW 77TH Ave Ste 107
Miami, FL 33166-2847 - Phone
- (786) 360-6034
- NPI assigned
- Jan 7, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Maria G Bou
- Title
- Ceo
- Phone
- (786) 360-6034
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
6801 NW 77TH Ave Ste 107
Miami, FL 33166-2847
Mailing address
6801 NW 77TH Ave Ste 107
Miami, FL 33166-2847
Phone (786) 360-6034
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HCC | Other | FL | HCC |
National Provider Directory
National Provider DirectoryLocations
6801 NW 77th Ave
Ste 107
Miami, FL 33166
Phone (786) 360-6034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578355200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618963200000",
"number": "1629618657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6801 NW 77TH AVE STE 107",
"city": "MIAMI",
"state": "FL",
"postal_code": "331662847",
"telephone_number": "786-360-6034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 NW 77TH AVE STE 107",
"city": "MIAMI",
"state": "FL",
"postal_code": "331662847",
"telephone_number": "786-360-6034"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CELESTIAL THERAPY GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-07",
"last_updated": "2021-04-21",
"certification_date": "2020-11-10",
"status": "A",
"authorized_official_last_name": "BOU",
"authorized_official_first_name": "MARIA",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "786-360-6034",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCC",
"identifier": "HCC",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.