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General NPI Number Information
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NPI Number | 1073362299
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Entity Type | Organization
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Legal Business Name | ALL CARE CONCIERGE MEDICINE LLC
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 4611 SW 3RD ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-1599
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Country | US
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Telephone | 786-548-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 4611 SW 3RD ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-1599
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | JUAN CARLOS GONZALEZ
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Credential | MD
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Telephone | 786-209-8966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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