Organization
SAN MIGUEL COMMUNITY WELLNESS CENTER
Active
Other names
SAN MIGUEL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL NOVOA (PRESIDENT)
(305) 432-4032
Entity
Organization
Contact information
Practice address
12030 SW 129TH CT STE 107, MIAMI, FL 33186-4584
(305) 432-4032
(855) 461-3440
Mailing address
12030 SW 129TH CT STE 107, MIAMI, FL 33186-4584
(305) 432-4032
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
10/24/2020
Last updated
01/25/2024
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