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8751 W Broward Blvd Ste 202 Plantation FL 33324-2630 | |
| (954) 874-8010 | |
| (954) 652-1541 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8751 W Broward Blvd Ste 202, Plantation, Florida |
| Authorized Official Name and Position | Michelle Montero-caicedo (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9547446332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8751 W Broward Blvd Ste 202 Plantation FL 33324-2630 Ph: (954) 874-8010 | 8751 W Broward Blvd Ste 202 Plantation FL 33324-2630 Ph: (954) 874-8010 |
| NPI Number | 1740667237 |
|---|---|
| Provider Enumeration Date | 05/04/2015 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740667237 | NPI | - | NPPES |
| 014823900 | Medicaid | FL |
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