Organization
CMS/MCH PRIMARY CARE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MANUELLA JANVIER-ANGLADE RN (PROGRAM ADMINISTRATOR)
(786) 624-2490
Entity
Organization
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(786) 624-2490
(786) 624-5790
Mailing address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(786) 624-2490
(786) 624-5790
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010060914
—
FL
Enumeration date
03/17/2006
Last updated
06/13/2008
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