Provider Demographics
NPI:1720485972
Name:META-FAMILY COUNSELING CENTER OF SOUTH FLORIDA LLC
Entity Type:Organization
Organization Name:META-FAMILY COUNSELING CENTER OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-431-2504
Mailing Address - Street 1:9100 S DADELAND BLVD
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7814
Mailing Address - Country:US
Mailing Address - Phone:305-431-2504
Mailing Address - Fax:
Practice Address - Street 1:9100 S DADELAND BLVD
Practice Address - Street 2:SUITE 1500
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7814
Practice Address - Country:US
Practice Address - Phone:305-431-2504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11708251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health