Organization
MAGNOLIA COMMUNITY MENTAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNAMYS MIRALLES (OWNER)
(813) 443-5530
Entity
Organization
Contact information
Practice address
2513 W HILLSBOROUGH AVE STE 210, TAMPA, FL 33614-6122
(813) 450-1052
Mailing address
2513 W HILLSBOROUGH AVE STE 210, TAMPA, FL 33614-6122
(813) 450-1052
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
04/14/2026
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