Organization
PSYCHOSOMA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS R. MADERAL M.A., M.DIV. (OWNER PRESIDENT DIRECTOR)
(305) 221-5366
Entity
Organization
Contact information
Practice address
8766 SW 8TH ST, MIAMI, FL 33174-3201
(305) 221-5366
(305) 667-9496
Mailing address
6750 SW 104TH ST, MIAMI, FL 33156-3252
(305) 221-5366
(305) 667-9496
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
04/26/2007
Last updated
08/22/2020
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