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General NPI Number Information
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NPI Number | 1538566682
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Entity Type | Organization
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Legal Business Name | RAY OF LIGHT HEALTH CARE INC
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 12/04/2014
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Provider Practice Location Address
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Address Line | 12862 SW 55TH ST
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City | MIAMI
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State | FL
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Zip | 33175-6214
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Country | US
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Telephone | 786-399-9946
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Fax |
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Provider Business Mailing Address
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Address Line | 12862 SW 55TH ST
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City | MIAMI
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State | FL
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Zip | 33175-6214
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Country | US
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Telephone | 786-399-9946
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. CARLOS ALBERTO PEREZ
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Credential |
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Telephone | 786-399-9946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State | FL
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Taxonomy #2
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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 | FL
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