Organization
COMMUNITY BEHAVIORAL MANAGEMENT,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDICE GISEL CARRILLO CABRERA (PRESIDENT)
(954) 589-2539
Entity
Organization
Contact information
Practice address
3 SW 129TH AVE STE 203, PEMBROKE PINES, FL 33027-1779
(954) 589-2539
Mailing address
9440 NW 35TH CT, MIAMI, FL 33147-2730
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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