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General NPI Number Information
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NPI Number | 1790095875
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Entity Type | Individual
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Provider Name | GYPSY ELAINE RIOS-SERRANO LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/07/2010
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 3001 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6824
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Country | US
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Telephone | 305-450-8930
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Fax |
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Provider Business Mailing Address
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Address Line | 11831 SW 196 STREET
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City | MIAMI
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State | FL
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Zip | 33177-4358
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Country | US
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Telephone | 305-450-8930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP4764
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH8873
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License Number State | FL
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