Individual
MAYRETH GONZALEZ PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CBHCMS
Contact information
Practice address
14505 COMMERCE WAY STE 750, MIAMI LAKES, FL 33016-1514
(305) 362-9989
Mailing address
8306 COMMERCE WAY APT 241, MIAMI LAKES, FL 33016-1610
(786) 398-1366
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMS101245
FL
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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