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General NPI Number Information
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NPI Number | 1144497819
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Entity Type | Organization
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Legal Business Name | NUEVO CAMINAR MC
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 1030 E 8TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010
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Country | US
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Telephone | 305-863-3355
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Fax | 305-825-0508
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Provider Business Mailing Address
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Address Line | 1030 E 8TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010
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Country | US
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Telephone | 305-863-3355
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Fax | 305-825-0508
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. CARLOS SOTOMAYOR ALBERTO SOTOMAYOR
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Credential |
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Telephone | 786-443-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 1113AD888901
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License Number State | FL
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