| Children & Parents Aba & Counseling Center Corp | |
|
4504 Wishart Pl Tampa FL 33603-2724 | |
| (813) 348-4814 | |
| (813) 348-0944 |
| Full Name | Children & Parents Aba & Counseling Center Corp |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4504 Wishart Pl, Tampa, Florida |
| Authorized Official Name and Position | Mario J Gonzalez Fernandez (CFO) |
| Authorized Official Contact | 8137755429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Children & Parents Aba & Counseling Center Corp 4504 Wishart Pl Tampa FL 33603-2724 Ph: (813) 348-4814 | Children & Parents Aba & Counseling Center Corp 4504 Wishart Pl Tampa FL 33603-2724 Ph: (813) 348-4814 |
| NPI Number | 1710675376 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/01/2023 |
| Certification Date | 05/01/2023 |
| Medicare PECOS PAC ID | 7719348424 |
|---|---|
| Medicare Enrollment ID | O20230727002731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710675376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mario Jorge Gonzalez Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427479310 PECOS PAC ID: 5597055657 Enrollment ID: I20160601001388 |
| Provider Name | Yunexi Giral |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811634850 PECOS PAC ID: 6002297298 Enrollment ID: I20220719003169 |
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