| NPI | 1821716705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED CINTRON Credentialing 561-235-7683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2022-08-17 |