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General NPI Number Information
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NPI Number | 1184640971
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Entity Type | Organization
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Legal Business Name | GREEN CROSS INC.
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2645 SW 37TH AVE
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City | MIAMI
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State | FL
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Zip | 33133-2754
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Country | US
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Telephone | 305-442-0633
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Fax | 305-442-9537
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Provider Business Mailing Address
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Address Line | 2645 SW 37TH AVE
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City | MIAMI
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State | FL
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Zip | 33133-2754
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Country | US
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Telephone | 305-442-0633
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Fax | 305-442-9537
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Authorized Official
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Title or Position | CEO
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Name | DR. MIGUEL ANGEL NUNEZ JR.
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Credential | M.D.
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Telephone | 305-442-0633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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