| Dynamic Waves Of Change | |
|
2020 Ne 163rd St #204 North Miami Beach FL 33162-4927 | |
| (786) 345-1510 | |
| (305) 705-3236 |
| Full Name | Dynamic Waves Of Change |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2020 Ne 163rd St, North Miami Beach, Florida |
| Authorized Official Name and Position | Pavel Abramov (OWNER) |
| Authorized Official Contact | 3059168818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Waves Of Change 3700 Sw 54th St Fort Lauderdale FL 33312-5670 Ph: (305) 916-8818 | Dynamic Waves Of Change 2020 Ne 163rd St #204 North Miami Beach FL 33162-4927 Ph: (786) 345-1510 |
| NPI Number | 1528484409 |
|---|---|
| Provider Enumeration Date | 03/15/2014 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528484409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CAP 4003 (Florida) | Primary |
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