| Sunnyside Love Extravagant Group | |
|
1701 W Flagler St Ste 310 Miami FL 33135-2099 | |
| (786) 467-7006 | |
| (786) 999-0971 |
| Full Name | Sunnyside Love Extravagant Group |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1701 W Flagler St Ste 310, Miami, Florida |
| Authorized Official Name and Position | Tabitha Sherelle Taylor-boone (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7865753801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunnyside Love Extravagant Group 2790 River Run Cir E Miramar FL 33025-4429 Ph: (786) 575-3801 | Sunnyside Love Extravagant Group 1701 W Flagler St Ste 310 Miami FL 33135-2099 Ph: (786) 467-7006 |
| NPI Number | 1750945689 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 07/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750945689 | NPI | - | NPPES |
| 022925900 | Medicaid | FL |
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