| NPI | 1386092427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY OQUENDO-ORTIZ Practice Manager 305-204-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker Clinical | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2025-03-24 |