Organization
CELESTIAL THERAPY GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARIA G BOU (CEO)
(786) 360-6034
Entity
Organization
Contact information
Practice address
6801 NW 77TH AVE STE 107, MIAMI, FL 33166-2847
(786) 360-6034
Mailing address
6801 NW 77TH AVE STE 107, MIAMI, FL 33166-2847
(786) 360-6034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC
HCC
FL
Enumeration date
01/07/2020
Last updated
04/21/2021
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