| Altagrace Lindsay Gustave, | |
|
2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133-2740 | |
| (305) 646-0112 | |
| Not Available |
| Full Name | Altagrace Lindsay Gustave |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 2780 Sw 37th Ave Ste 206, Coconut Grove, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619642519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | IMH18061 (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | MH22040 (Florida) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Altagrace Lindsay Gustave, 1175 Ne 147th St, North Miami, FL 33161-2442 Ph: (786) 277-7394 | Altagrace Lindsay Gustave, 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133-2740 Ph: (305) 646-0112 |
Ms. Xiomara Contreras, RMHCI Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133 Phone: 305-646-0112 Fax: 305-646-0113 | |
Jessika Guadalupe Abdalah, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133 Phone: 305-646-0112 | |
Jessica Lee Olivo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133 Phone: 305-646-0112 | |
Amelia Behney, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133 Phone: 305-646-0112 | |
Laura Solorzano, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133 Phone: 305-646-0112 | |
Mr. Jorge Alberto Lopez Ii, MASTERS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Ssw 37th Ave, Coconut Grove, FL 33133 Phone: 786-234-1980 | |
Elisa M Urtiaga, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2780 Sw 37th Ave Ste 206, Coconut Grove, FL 33133 Phone: 305-646-0112 |