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General NPI Number Information
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NPI Number | 1255918942
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Entity Type | Organization
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Legal Business Name | CORAL WAY HEALTH CENTER CORP
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Dates
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Enumeration Date | 03/27/2021
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 12855 SW 132ND ST STE 207A
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City | MIAMI
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State | FL
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Zip | 33186-7207
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Country | US
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Telephone | 305-608-5572
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Fax | 786-250-5094
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Provider Business Mailing Address
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Address Line | 9159 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-2302
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Country | US
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Telephone | 305-392-1274
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Fax | 786-953-5752
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Authorized Official
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Title or Position | PRESIDENT
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Name | GISELLE L GARCIA
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Credential | LMHC
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Telephone | 305-392-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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