Provider Demographics
NPI:1972105369
Name:CARDINALS CARE C.M.H.C.
Entity Type:Organization
Organization Name:CARDINALS CARE C.M.H.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA NUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-797-7788
Mailing Address - Street 1:2100 PONCE DE LEON BLVD STE 1015
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5240
Mailing Address - Country:US
Mailing Address - Phone:786-797-7788
Mailing Address - Fax:
Practice Address - Street 1:2100 PONCE DE LEON BLVD STE 1015
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5240
Practice Address - Country:US
Practice Address - Phone:786-797-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health