Organization
LONG LIFE THERAPY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETICIA HERNANDEZ RODRIGUEZ (OWNER)
(786) 218-6506
Entity
Organization
Contact information
Practice address
4790 NW 7TH ST STE 102, MIAMI, FL 33126-2200
(786) 218-6506
Mailing address
4790 NW 7TH ST STE 102, MIAMI, FL 33126-2200
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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