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General NPI Number Information
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NPI Number | 1508759713
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Entity Type | Organization
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Legal Business Name | SPECTRUM DISCOVERY CENTER INC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 8550 W FLAGLER ST STE 113
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City | MIAMI
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State | FL
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Zip | 33144-2037
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Country | US
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Telephone | 305-934-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 8550 W FLAGLER ST STE 113
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City | MIAMI
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State | FL
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Zip | 33144-2037
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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 | ADMINISTRATOR
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Name | OXANA GARKAVCHENKO
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Credential |
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Telephone | 786-486-6766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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