| NPI | 1649733544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL A DIAZ Owner 239-464-3310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-01-25 |