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General NPI Number Information
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NPI Number | 1578801122
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Entity Type | Organization
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Legal Business Name | FAMILY PROTECTIVE SERVICES, CORP.
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 13200 SW 70TH AVE
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City | MIAMI
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State | FL
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Zip | 33156-6948
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Country | US
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Telephone | 786-343-4474
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Fax |
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Provider Business Mailing Address
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Address Line | 13200 SW 70TH AVE
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City | MIAMI
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State | FL
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Zip | 33156-6948
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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 | EXECUTIVE DIRECTOR
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Name | MR. JOHN A PIEDRAHITA
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Credential | L.M.H.C.
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Telephone | 786-343-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH11418
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License Number State | FL
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