Organization
LAS OLAS COMMUNITY HEALTH CORP
Active
Organization
LAS OLAS COMMUNITY HEALTH CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ILKA CANCIO-ALONSO (AUTHORIZED OFFICIAL)
(786) 614-6736
Entity
Organization
Contact information
Practice address
4005 NW 114TH AVE UNIT 22, DORAL, FL 33178-4373
(786) 614-6736
Mailing address
4005 NW 114TH AVE UNIT 22, DORAL, FL 33178-4373
(786) 614-6736
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021009669
LICENSE
FL
Enumeration date
03/04/2021
Last updated
03/04/2021
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