Organization
FAMILY CARE MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIER VALDES BANGUELA (OWNER)
(813) 703-0016
Entity
Organization
Contact information
Practice address
9340 N FLORIDA AVE STE F, TAMPA, FL 33612-7925
(813) 703-0016
Mailing address
13919 BRIARDALE LN, TAMPA, FL 33618-2115
(813) 703-0016
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109316300
—
FL
Enumeration date
01/05/2021
Last updated
04/04/2021
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