Provider Demographics
NPI:1942041652
Name:SOUL HEALTH CENTER LLC
Entity type:Organization
Organization Name:SOUL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUGDADES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRIGIO SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-308-8253
Mailing Address - Street 1:5911 NW 173RD DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5121
Mailing Address - Country:US
Mailing Address - Phone:786-307-8253
Mailing Address - Fax:
Practice Address - Street 1:5911 NW 173RD DR
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33015-5121
Practice Address - Country:US
Practice Address - Phone:786-307-8253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)