Healthcare Provider Details

I. General information

NPI: 1003747650
Provider Name (Legal Business Name): INTERNATIONAL CHILDREN RELIEF FUNDATION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9920 N KENDALL DR APT J406
MIAMI FL
33176-1763
US

IV. Provider business mailing address

9920 N KENDALL DR APT J406
MIAMI FL
33176-1763
US

V. Phone/Fax

Practice location:
  • Phone: 786-503-0203
  • Fax:
Mailing address:
  • Phone: 786-503-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1103X
TaxonomyMilitary Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS ANTONIO VILLARREAL PINTO SR.
Title or Position: NEUROLOGY
Credential: PHD MD
Phone: 786-503-0203