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General NPI Number Information
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NPI Number | 1871843045
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Entity Type | Organization
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Legal Business Name | FAMILY RESOURCE CENTER OF SOUTH FLORIDA
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 155 SOUTH MIAMI AVE SUITE 400
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City | MIAMI
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State | FL
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Zip | 33137
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Country | US
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Telephone | 305-812-2902
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Fax |
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Provider Business Mailing Address
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Address Line | 155 S MIAMI AVE SUITE 400
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City | MIAMI
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State | FL
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Zip | 33130-1617
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Country | US
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Telephone | 305-812-2902
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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 | DR. OREN WUNDERMAN
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Credential | PHD
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Telephone | 305-960-5521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NONE
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License Number State | FL
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