| My Roots Of Life | |
|
12863 Sw 42nd St Miami FL 33175-3434 | |
| (786) 234-1609 | |
| Not Available |
| Full Name | My Roots Of Life |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 12863 Sw 42nd St, Miami, Florida |
| Authorized Official Name and Position | Vilma Garrido Riquenes (LICENSE MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 7862341609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Roots Of Life 17025 Nw 52nd Pl Miami Gardens FL 33055-4018 Ph: (786) 234-1609 | My Roots Of Life 12863 Sw 42nd St Miami FL 33175-3434 Ph: (786) 234-1609 |
| NPI Number | 1053151902 |
|---|---|
| Provider Enumeration Date | 05/29/2024 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053151902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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