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General NPI Number Information
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NPI Number | 1255645800
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Entity Type | Organization
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Legal Business Name | CORAL THERAPY CENTER INC
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 5200 SW 8TH ST SUITE 117
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City | CORAL GABLES
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State | FL
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Zip | 33134-2300
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Country | US
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Telephone | 786-399-8015
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 SW 8TH ST SUITE 117
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City | CORAL GABLES
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State | FL
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Zip | 33134-2300
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Country | US
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Telephone | 786-399-8015
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | TOMAS BRITO
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Credential |
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Telephone | 786-399-8015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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