Envision Wellness Co.
Clinical Neuropsychologist in Miami, FL. Organization (NPI-2).
NPI number1982017513
StatusActive
Last updated in NPPESOct 26, 2017
Details
- NPI
- 1982017513
- Entity type
- Organization (NPI-2)
- Legal business name
- Envision Wellness Co.
- Organization subpart
- No
- Enumeration date
- Jun 11, 2014
- Last updated
- Oct 26, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY 8965 | FL | Yes |
Practice location
1900 Sw 57th Ave Ste 2Miami, FL 33155-2170
Phone 305-501-0133
Mailing address
1900 Sw 57th Ave Ste 2Miami, FL 33155-2170
Phone 305-501-0133
Authorized official
Erika Martinez
President
3055010133
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