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General NPI Number Information
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NPI Number | 1508213570
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Entity Type | Organization
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Legal Business Name | MHB CONSULTANT
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 7855 NW 12TH ST # 117
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City | DORAL
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State | FL
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Zip | 33126-1826
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Country | US
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Telephone | 305-742-2198
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Fax |
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Provider Business Mailing Address
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Address Line | 235 W 56TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-2738
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | R.B.T
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Name | DR. ILEANA LUCIA ALVAREZ I
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Credential |
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Telephone | 786-346-7605
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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 | 15-01490
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License Number State | FL
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