| Miyas Place Llc | |
|
2500 Hollywood Blvd Ste 104 Hollywood FL 33020-6615 | |
| (305) 903-2505 | |
| Not Available |
| Full Name | Miyas Place Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2500 Hollywood Blvd Ste 104, Hollywood, Florida |
| Authorized Official Name and Position | Daneisha Freeman (MANAGER) |
| Authorized Official Contact | 3059032505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miyas Place Llc 1530 Sw 109th Ave Apt 205 Pembroke Pines FL 33025-5544 Ph: (305) 903-2505 | Miyas Place Llc 2500 Hollywood Blvd Ste 104 Hollywood FL 33020-6615 Ph: (305) 903-2505 |
| NPI Number | 1184403255 |
|---|---|
| Provider Enumeration Date | 09/27/2023 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184403255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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