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General NPI Number Information
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NPI Number | 1801376850
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Entity Type | Organization
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Legal Business Name | SOUTH MIAMI RECOVERY, INC
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 7520 SW 57 AVE STE E-1
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City | MIAMI
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State | FL
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Zip | 33173-3317
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Country | US
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Telephone | 305-733-9655
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Fax |
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Provider Business Mailing Address
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Address Line | 7520 SW 57TH AVE STE E1
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5330
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Country | US
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Telephone | 305-733-9655
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. HOWARD LERNER
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Credential |
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Telephone | 305-733-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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