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General NPI Number Information
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NPI Number | 1285688705
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Entity Type | Organization
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Legal Business Name | SUDDEN CARE OPTIONS CMHC INC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 1421 SW 107TH AVE SUITE 2
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City | MIAMI
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State | FL
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Zip | 33174-2509
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Country | US
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Telephone | 305-229-9021
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Fax | 305-229-9031
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Provider Business Mailing Address
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Address Line | 1421 SW 107TH AVE SUITE 2
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City | MIAMI
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State | FL
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Zip | 33174-2509
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Country | US
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Telephone | 305-229-9021
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Fax | 305-229-9031
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Authorized Official
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Title or Position | OWNER/PRESIDENT/ADMINISTRATOR
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Name | MR. FRANCISCO ALBERTO PENA JR.
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Credential | LMHC
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Telephone | 305-229-9021
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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 | HCC5199
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License Number State | FL
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