Organization
KETAMINE HEALTH CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL A CRUZ MD (MEDICAL DIRECTOR)
(305) 856-9442
Entity
Organization
Contact information
Practice address
9408 SW 87TH AVE STE 302, MIAMI, FL 33176-2416
(305) 856-9442
Mailing address
9408 SW 87TH AVE STE 302, MIAMI, FL 33176-2416
(305) 856-9442
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
607228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104163294
—
FL
05
—
1144421454
—
FL
05
—
1194817221
—
FL
05
—
187533935
—
FL
Enumeration date
05/29/2018
Last updated
07/31/2023
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