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General NPI Number Information
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NPI Number | 1679207930
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Entity Type | Organization
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Legal Business Name | CENTRO PSICOTERAPEUTICO GARCIA -MAYOR LLC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 22310 WOODMEN HALL DR
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City | LAND O LAKES
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State | FL
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Zip | 34637-3386
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Country | US
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Telephone | 239-888-1218
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Fax | 239-203-2226
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Provider Business Mailing Address
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Address Line | 1215 CALLE CANADA
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City | SAN JUAN
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State | PR
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Zip | 00920-3854
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Country | US
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Telephone | 239-888-1218
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Fax | 239-203-2226
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Authorized Official
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Title or Position | OWNER
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Name | JOSE GRACIA MAYOR
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Credential |
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Telephone | 239-888-1218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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