Organization
FENIX COUNSELING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTOBAL J GONZALEZ LMHC (PRESIDENT)
(305) 788-6553
Entity
Organization
Contact information
Practice address
8201 PETERS RD, SUITE 1000, PLANTATION, FL 33324-3265
(954) 916-2618
Mailing address
8201 PETERS RD, SUITE 1000, PLANTATION, FL 33324-3265
(954) 916-2618
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH7884
FL
302R00000X
Health Maintenance Organization
MH7884
FL
305R00000X
Preferred Provider Organization
MH7884
FL
305S00000X
Point of Service
MH7884
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265452627
—
FL
Enumeration date
06/01/2015
Last updated
06/01/2015
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