Provider Demographics
NPI:1629897079
Name:BOSCH, FABIO
Entity type:Individual
Prefix:
First Name:FABIO
Middle Name:
Last Name:BOSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 NW 3RD ST APT 308
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33128-1490
Mailing Address - Country:US
Mailing Address - Phone:305-462-7433
Mailing Address - Fax:
Practice Address - Street 1:726 NW 3RD ST APT 308
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1490
Practice Address - Country:US
Practice Address - Phone:305-462-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist