Organization
DYNAMIC WAVES OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVEL ABRAMOV (OWNER)
(305) 916-8818
Entity
Organization
Contact information
Practice address
2020 NE 163RD ST, #204, NORTH MIAMI BEACH, FL 33162-4927
(786) 345-1510
(305) 705-3236
Mailing address
3700 SW 54TH ST, FORT LAUDERDALE, FL 33312-5670
(305) 916-8818
(305) 705-3236
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP 4003
FL
Other
Enumeration date
03/15/2014
Last updated
05/12/2021
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