Organization
MHB CONSULTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILEANA LUCIA ALVAREZ I (R.B.T)
(786) 346-7605
Entity
Organization
Contact information
Practice address
7855 NW 12TH ST # 117, DORAL, FL 33126-1826
(305) 742-2198
Mailing address
235 W 56TH ST, HIALEAH, FL 33012-2738
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15-01490
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090268
—
FL
Enumeration date
05/19/2016
Last updated
05/19/2016
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