Provider Demographics
NPI:1407132301
Name:SURVIVORS PATHWAY CENTER
Entity Type:Organization
Organization Name:SURVIVORS PATHWAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCESCO
Authorized Official - Middle Name:DUBERLI
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:305-299-1957
Mailing Address - Street 1:1801 CORAL WAY
Mailing Address - Street 2:OFC 411
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2790
Mailing Address - Country:US
Mailing Address - Phone:305-299-1957
Mailing Address - Fax:786-484-0411
Practice Address - Street 1:1801 CORAL WAY
Practice Address - Street 2:OFC 411
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2790
Practice Address - Country:US
Practice Address - Phone:305-299-1957
Practice Address - Fax:786-484-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH8226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty