Provider Demographics
NPI:1043264229
Name:BAIRES ENTERPRISES LTD CO
Entity type:Organization
Organization Name:BAIRES ENTERPRISES LTD CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUPIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:305-262-5967
Mailing Address - Street 1:17962 SW 29TH LN
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5500
Mailing Address - Country:US
Mailing Address - Phone:786-326-6322
Mailing Address - Fax:
Practice Address - Street 1:137 SW 57TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3411
Practice Address - Country:US
Practice Address - Phone:305-262-5967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA649Medicare PIN