Individual
CATHERINE GONGORA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBHCM
Contact information
Practice address
15931 SW 81ST ST, MIAMI, FL 33193-3064
(786) 234-8164
(786) 321-9039
Mailing address
15931 SW 81ST ST, MIAMI, FL 33193-3064
(786) 234-8164
(786) 321-9039
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM.0104051
FL
Other
Enumeration date
12/21/2020
Last updated
03/06/2025
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