| NPI | 1669810933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERIBERTO M ORTIZ President 305-274-2403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL 549) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY6187) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |