| Sports Konnect Youth Move | |
|
2103 Coral Way Fl 2 Coral Gables FL 33145-2601 | |
| (786) 235-8030 | |
| Not Available |
| Full Name | Sports Konnect Youth Move |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2103 Coral Way Fl 2, Coral Gables, Florida |
| Authorized Official Name and Position | Devin A Browne (OWNER) |
| Authorized Official Contact | 7863823014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Konnect Youth Move 2103 Coral Way Fl 2 Coral Gables FL 33145-2601 Ph: (786) 235-8030 | Sports Konnect Youth Move 2103 Coral Way Fl 2 Coral Gables FL 33145-2601 Ph: (786) 235-8030 |
| NPI Number | 1154956639 |
|---|---|
| Provider Enumeration Date | 03/05/2020 |
| Last Update Date | 03/16/2020 |
| Certification Date | 03/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154956639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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