Provider Demographics
NPI:1548090855
Name:PROFESSIONAL CARE SOLUTION LLC
Entity type:Organization
Organization Name:PROFESSIONAL CARE SOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARLIES
Authorized Official - Middle Name:T
Authorized Official - Last Name:GONZALEZ LLANTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-803-8827
Mailing Address - Street 1:9600 SW 8TH ST STE 16
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2947
Mailing Address - Country:US
Mailing Address - Phone:786-803-8827
Mailing Address - Fax:786-803-8577
Practice Address - Street 1:9600 SW 8TH ST STE 16
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2947
Practice Address - Country:US
Practice Address - Phone:786-803-8827
Practice Address - Fax:786-803-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health