Healthcare Provider Details

I. General information

NPI: 1245942333
Provider Name (Legal Business Name): COMPREHENSIVE COUNSELING & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 HAMMOCKS BLVD STE 123
MIAMI FL
33196-3783
US

IV. Provider business mailing address

10201 HAMMOCKS BLVD STE 123
MIAMI FL
33196-3783
US

V. Phone/Fax

Practice location:
  • Phone: 786-577-3427
  • Fax: 305-402-3728
Mailing address:
  • Phone: 786-577-3427
  • Fax: 305-402-3728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YUSLEY PEREZ
Title or Position: ADMIN
Credential:
Phone: 786-577-3427