Organization
EBENEZER WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDIRA JIMENEZ (OWNER)
(786) 285-3438
Entity
Organization
Contact information
Practice address
1200 NW 78TH AVE STE 210, DORAL, FL 33126-1817
(786) 285-3438
Mailing address
1200 NW 78TH AVE STE 210, DORAL, FL 33126-1817
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
03/20/2023
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