| Desigual Therapy Services Inc | |
|
717 Ponce De Leon Blvd Ste 307 Coral Gables FL 33134-2070 | |
| (305) 952-3247 | |
| (305) 952-3248 |
| Full Name | Desigual Therapy Services Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 717 Ponce De Leon Blvd Ste 307, Coral Gables, Florida |
| Authorized Official Name and Position | Indira A Alvarez Saenz (PRESIDENT) |
| Authorized Official Contact | 7866124461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desigual Therapy Services Inc 717 Ponce De Leon Blvd Ste 307 Coral Gables FL 33134-2070 Ph: (305) 952-3247 | Desigual Therapy Services Inc 717 Ponce De Leon Blvd Ste 307 Coral Gables FL 33134-2070 Ph: (305) 952-3247 |
| NPI Number | 1578108403 |
|---|---|
| Provider Enumeration Date | 11/14/2019 |
| Last Update Date | 01/20/2025 |
| Certification Date | 01/20/2025 |
| Medicare PECOS PAC ID | 6305201534 |
|---|---|
| Medicare Enrollment ID | O20230424000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578108403 | NPI | - | NPPES |
| 106429700 | Medicaid | FL | |
| 118942700 | Medicaid | FL | |
| 124183500 | Medicaid | FL | |
| 104809400 | Medicaid | FL | |
| 115630300 | Medicaid | FL |
| Provider Name | Domingo J Leal |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518975002 PECOS PAC ID: 0840588547 Enrollment ID: I20161012002532 |
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