Organization
SOUTH FLORIDA ADHD CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARISELA CARMEN JAQUEZ-GUTIERREZ M.D. (PRESIDENT)
(305) 392-6784
Entity
Organization
Contact information
Practice address
17901 NW 5TH ST STE 103, PEMBROKE PINES, FL 33029-2810
(305) 392-6784
Mailing address
11341 NW 50TH TER, DORAL, FL 33178-3545
(305) 392-6784
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME70979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251098700
—
FL
Enumeration date
12/13/2011
Last updated
12/13/2011
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