Organization
MIAMI OUTPATIENT DETOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT IANNUCCI (CEO)
(561) 789-9034
Entity
Organization
Contact information
Practice address
175 SW 7TH ST, SUITE 1102, MIAMI, FL 33130-2992
(800) 990-0340
Mailing address
175 SW 7TH ST, SUITE 1102, MIAMI, FL 33130-2992
(800) 990-0340
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
06/17/2011
Last updated
12/17/2012
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