Organization
COMMUNITY MENTAL HEALTH AND WELLNESS CENTER OF DORAL INC
Active
Organization
COMMUNITY MENTAL HEALTH AND WELLNESS CENTER OF DORAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA RODRIGUEZ (PRESIDENT)
(786) 490-0974
Entity
Organization
Contact information
Practice address
9300 NW 25TH ST STE 106, DORAL, FL 33172-1506
(786) 320-4603
Mailing address
9300 NW 25TH ST STE 106, DORAL, FL 33172-1506
(786) 320-4603
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
—
—
2084P0800X
Psychiatry Physician
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC12703
AHCA
FL
Enumeration date
07/13/2017
Last updated
03/27/2018
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