| Keys Gate Wellness Associates, Llc | |
|
100 Ne 15th St Ste 101d Homestead FL 33030-4564 | |
| (833) 779-8646 | |
| Not Available |
| Full Name | Keys Gate Wellness Associates, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 100 Ne 15th St Ste 101d, Homestead, Florida |
| Authorized Official Name and Position | Jacqueline Santana Sparber (PSYCHOLOGIST/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3054096679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keys Gate Wellness Associates, Llc 14213 Sw 289th Ter Homestead FL 33033-2989 Ph: (305) 409-6679 | Keys Gate Wellness Associates, Llc 100 Ne 15th St Ste 101d Homestead FL 33030-4564 Ph: (833) 779-8646 |
| NPI Number | 1033751037 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 10/10/2019 |
| Medicare PECOS PAC ID | 3577953314 |
|---|---|
| Medicare Enrollment ID | O20211209001208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033751037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lyllymar Colon Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720683345 PECOS PAC ID: 5890195515 Enrollment ID: I20210616002273 |
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