Organization
CENTER FOR HUMAN FORMATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS CAMILO GOMEZ PHD (PSYCHOLOGIST)
(786) 879-7007
Entity
Organization
Contact information
Practice address
301 ALMERIA AVE, SUITE 210, CORAL GABLES, FL 33134-5822
(786) 879-7007
Mailing address
PO BOX 140432, CORAL GABLES, FL 33114-0432
(786) 879-7007
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 7327
FL
Other
Enumeration date
12/22/2009
Last updated
07/20/2011
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