Basic Information
| Provider Information | |||||||||
| NPI: | 1801351333 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARGENAL | ||||||||
| FirstName: | OTILIA | ||||||||
| MiddleName: | DAMARIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9100 S. DADELAND BLVD | ||||||||
| Address2: | SUITE 1500 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331567188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059298705 | ||||||||
| FaxNumber: | 3056003713 | ||||||||
| Practice Location | |||||||||
| Address1: | 9100 S. DADELAND BLVD | ||||||||
| Address2: | SUITE 1500 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331567188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059298705 | ||||||||
| FaxNumber: | 3056003713 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2019 | ||||||||
| LastUpdateDate: | 04/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | N | Behavioral Health & Social Service Providers | Social Worker | School | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.