Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 1613 Gattis Dr, Orlando, Florida |
Authorized Official Name and Position | Jorge M Santaella (LICENSED MENTAL HEALTH COUNSEL) |
Authorized Official Contact | 7732189651 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1613 Gattis Dr Orlando FL 32825-5409 Ph: (312) 450-4444 | 1613 Gattis Dr Orlando FL 32825 Ph: (773) 218-9651 |
NPI Number | 1063939163 |
---|---|
Provider Enumeration Date | 08/29/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063939163 | NPI | - | NPPES |
MH16047 | Other | FL | PRIVATE HEALTH INSURANCE PROVIDERS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | MH16047 (Florida) | Primary |
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