Provider Demographics
NPI:1528470671
Name:GRSO BIOMECHANICS INCORPORATED
Entity type:Organization
Organization Name:GRSO BIOMECHANICS INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-815-7442
Mailing Address - Street 1:75 VALENCIA AVE
Mailing Address - Street 2:SUITE 704
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6141
Mailing Address - Country:US
Mailing Address - Phone:305-441-2888
Mailing Address - Fax:
Practice Address - Street 1:75 VALENCIA AVE
Practice Address - Street 2:SUITE 704
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6141
Practice Address - Country:US
Practice Address - Phone:305-441-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty