| Mental Health Evolution Llc | |
|
5915 Ponce De Leon Blvd Coral Gables FL 33146-2435 | |
| (305) 934-6453 | |
| Not Available |
| Full Name | Mental Health Evolution Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5915 Ponce De Leon Blvd, Coral Gables, Florida |
| Authorized Official Name and Position | Diana Almeida Wallace (MANAGER) |
| Authorized Official Contact | 3059346453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Evolution Llc 5840 Sw 86th St South Miami FL 33143-8226 Ph: (305) 934-6453 | Mental Health Evolution Llc 5915 Ponce De Leon Blvd Coral Gables FL 33146-2435 Ph: (305) 934-6453 |
| NPI Number | 1215767462 |
|---|---|
| Provider Enumeration Date | 08/02/2024 |
| Last Update Date | 08/02/2024 |
| Certification Date | 08/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215767462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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