Organization
THE SHINE AGE A & L MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJO CARMENATES (PRESIDENT)
(786) 327-2957
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD STE 1N6, MIAMI, FL 33172-4511
(863) 277-2957
Mailing address
175 FONTAINEBLEAU BLVD STE 1N6, MIAMI, FL 33172-4511
(863) 277-2957
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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