Eugene, Mir Land
Eugene, Mir Land is an sole proprietor health care provider with primary practice located at 4469 Nw 167Th St , Opa Locka FL 33055-4311. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Eugene, Mir Land can be contacted via phone (305) 621-1455.Contact Information
Primary practice address
4469 Nw 167Th St
Opa Locka FL 33055-4311
Phone: (305) 621-1455
Fax: (305) 621-5508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1417991555 |
|---|---|
| LBN Legal business name | Eugene, Mir Land |
| Credentials | MA, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Mar 25th, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417991555 | NPPES |
| Florida | MEDICAID | 764792100 |
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