Organization
EXCEL EMPOWERMENT ZONE
Active
Other names
EXCEL EMPOWERMENT ZONE
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNTRAVIA POINTVILLE CEO (CEO)
(305) 624-0101
Entity
Organization
Contact information
Practice address
17700 NW 27TH AVE, MIAMI GARDENS, FL 33056-4010
(305) 624-0101
(305) 624-0191
Mailing address
17700 NW 27TH AVE, MIAMI GARDENS, FL 33056-4010
(305) 624-0101
(305) 624-0191
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17700
EXCEL PROVIDER
FL
Enumeration date
01/14/2021
Last updated
01/14/2021
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