Healthcare Provider Details

I. General information

NPI: 1649551680
Provider Name (Legal Business Name): MR. LUIS ABREU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2011
Last Update Date: 11/05/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 SW 28TH STREET BROWARD ADDICTION RECOVERY CENTER
FT. LAUDERDALE FL
33315
US

IV. Provider business mailing address

20900 BISCAYNE BLVD
AVENTURA FL
33180-1407
US

V. Phone/Fax

Practice location:
  • Phone: 954-357-4820
  • Fax:
Mailing address:
  • Phone: 305-766-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14678
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: