| Excel Empowerment Zone | |
|
17700 Nw 27th Ave Miami Gardens FL 33056-4010 | |
| (305) 624-0101 | |
| (305) 624-0191 |
| Full Name | Excel Empowerment Zone |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 17700 Nw 27th Ave, Miami Gardens, Florida |
| Authorized Official Name and Position | Shawntravia Pointville (CEO) |
| Authorized Official Contact | 3056240101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Empowerment Zone 17700 Nw 27th Ave Miami Gardens FL 33056-4010 Ph: (305) 624-0101 | Excel Empowerment Zone 17700 Nw 27th Ave Miami Gardens FL 33056-4010 Ph: (305) 624-0101 |
| NPI Number | 1295324267 |
|---|---|
| Provider Enumeration Date | 01/14/2021 |
| Last Update Date | 01/14/2021 |
| Certification Date | 01/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295324267 | NPI | - | NPPES |
| 17700 | Other | FL | EXCEL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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