Organization
NIRVANA CLINIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELA MANNO (DIRECTOR)
(786) 577-0024
Entity
Organization
Contact information
Practice address
8765 SW 165TH AVE STE 105, MIAMI, FL 33193-5832
(786) 577-0024
(786) 773-2234
Mailing address
8765 SW 165TH AVE STE 105, MIAMI, FL 33193-5832
(786) 577-0024
(786) 773-2234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/29/2016
Last updated
11/29/2021
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