| NPI | 1629128186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RAFAEL GONZALEZ-SOLTERO Owner 321-751-1925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2008-07-14 |