Provider Demographics
NPI:1659953206
Name:MIAMI LAKES HEALTH CENTER INC
Entity Type:Organization
Organization Name:MIAMI LAKES HEALTH CENTER INC
Other - Org Name:MIAMI LAKES HEALTH CENTER INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GRETTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-615-2545
Mailing Address - Street 1:8100 NW 155TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5865
Mailing Address - Country:US
Mailing Address - Phone:786-615-2545
Mailing Address - Fax:786-542-5084
Practice Address - Street 1:8100 NW 155TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5865
Practice Address - Country:US
Practice Address - Phone:786-615-2545
Practice Address - Fax:786-542-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251B00000XAgenciesCase Management