Organization
SPE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGI CAROLINA GONZALEZ (PRESIDENT)
(786) 419-6048
Entity
Organization
Contact information
Practice address
15190 SW 136TH ST STE 26, MIAMI, FL 33196-2618
(786) 419-6048
(888) 447-1402
Mailing address
15190 SW 136TH ST STE 26, MIAMI, FL 33196-2618
(786) 419-6048
(888) 447-1402
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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