Organization
N/A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE M HERNANDEZ MARTINEZ (OWNER)
(786) 835-4078
Entity
Organization
Contact information
Practice address
4800 W FLAGLER ST STE 106, CORAL GABLES, FL 33134-1400
(305) 448-7848
Mailing address
4800 W FLAGLER ST STE 106, CORAL GABLES, FL 33134-1400
(305) 448-7848
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/05/2024
Last updated
07/02/2024
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