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General NPI Number Information
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NPI Number | 1710105481
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Entity Type | Organization
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Legal Business Name | SOUL GATE INC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7135 COLLINS AVE SUITE 811
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City | MIAMI BEACH
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State | FL
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Zip | 33141-3238
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Country | US
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Telephone | 305-672-1589
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Fax | 305-672-1589
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Provider Business Mailing Address
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Address Line | 7135 COLLINS AVE SUITE 811
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City | MIAMI BEACH
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State | FL
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Zip | 33141-3238
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Country | US
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Telephone | 305-672-1589
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Fax | 305-672-1589
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Authorized Official
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Title or Position | PRESIDENT
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Name | SILVINA BELMONTE
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Credential | LMHC
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Telephone | 305-672-1589
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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 | MH0005080
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License Number State | FL
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