Organization Active NPI

Celestial Therapy Group Inc

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1629618657
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on Apr 21, 2021

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
HCCOtherFLHCC

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.