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General NPI Number Information
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NPI Number | 1003169525
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Entity Type | Organization
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Legal Business Name | COURT OPTIONS INC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 6555 NW 36TH ST SUITE 328
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6978
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Country | US
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Telephone | 305-378-8122
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Fax | 305-870-9921
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Provider Business Mailing Address
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Address Line | 6555 NW 36TH ST SUITE 328
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6978
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Country | US
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Telephone | 305-378-8122
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Fax | 305-870-9921
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RUBEN VALDIVIA
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Credential |
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Telephone | 305-378-8122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1113AD727801
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License Number State | FL
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