Healthcare Provider Details

I. General information

NPI: 1467651679
Provider Name (Legal Business Name): ONE HOPE UNITED- FLORIDA REGION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10720 CARIBBEAN BLVD SUITE 330
CUTLER BAY FL
33189
US

IV. Provider business mailing address

10720 CARIBBEAN BLVD SUITE 500
CUTLER BAY FL
33189
US

V. Phone/Fax

Practice location:
  • Phone: 786-712-0492
  • Fax: 786-242-5080
Mailing address:
  • Phone: 786-573-9000
  • Fax: 786-573-9003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSW5817
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW5817
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOLENE M PALAZZO-FORD
Title or Position: BUSINESS MANAGER- FLORIDA REGION
Credential: MBA
Phone: 407-399-2038