Provider Demographics
NPI:1669959698
Name:GABLES COMMUNITY WELLNESS CENTER INC
Entity type:Organization
Organization Name:GABLES COMMUNITY WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWE
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAJON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-907-9903
Mailing Address - Street 1:2255 SW 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3177
Mailing Address - Country:US
Mailing Address - Phone:561-907-9903
Mailing Address - Fax:
Practice Address - Street 1:2255 SW 32ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3177
Practice Address - Country:US
Practice Address - Phone:561-907-9903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health