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Organization
CRISTAL COMMUNITY HEALTH CENTER LLC
Active
Organization
CRISTAL COMMUNITY HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA PATRICIA GOMEZ (OWNER)
(786) 326-6308
Entity
Organization
Contact information
Practice address
931 SW 122ND AVE, MIAMI, FL 33184-2477
(786) 326-6308
Mailing address
931 SW 122ND AVE, MIAMI, FL 33184-2477
(786) 326-6308
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/20/2019
Last updated
01/28/2022
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