| Las Olas Community Health Corp | |
|
4005 Nw 114th Ave Unit 22 Doral FL 33178-4373 | |
| (786) 614-6736 | |
| Not Available |
| Full Name | Las Olas Community Health Corp |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4005 Nw 114th Ave Unit 22, Doral, Florida |
| Authorized Official Name and Position | Ilka Cancio-alonso (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7866146736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Las Olas Community Health Corp 4005 Nw 114th Ave Unit 22 Doral FL 33178-4373 Ph: (786) 614-6736 | Las Olas Community Health Corp 4005 Nw 114th Ave Unit 22 Doral FL 33178-4373 Ph: (786) 614-6736 |
| NPI Number | 1356936124 |
|---|---|
| Provider Enumeration Date | 03/04/2021 |
| Last Update Date | 03/04/2021 |
| Certification Date | 03/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356936124 | NPI | - | NPPES |
| 2021009669 | Other | FL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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