| NPI | 1083441208 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LISNEY RODRIGUEZ GUTIERREZ Pmhnp 786-228-6892 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Enumeration Date | 2024-09-19 | 
| Last Update Date | 2025-09-10 |