Willow Tree Community Center Corp

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WILLOW TREE COMMUNITY CENTER CORP

Practice address

10689 N Kendall Dr Ste 309
Miami, FL 33176-1525

Phone

(786) 536-7470

Fax

(786) 536-7951

NPI assigned

Jun 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Israel Romero

Title

Owner

Phone

(305) 824-6021

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1841850203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10689 N KENDALL DR STE 309",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761525",
            "telephone_number": "786-536-7470",
            "fax_number": "786-536-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10689 N KENDALL DR STE 309",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761525",
            "telephone_number": "786-536-7470",
            "fax_number": "786-536-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE COMMUNITY CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-824-6021"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Miami",
            "affiliation": "N",
            "address_1": "10689 N Kendall Dr Ste 309",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331761525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Bryan Ross Wilner, M.D.
• Rose Wilson-Bennett, R.N.
• Kathleen Wilson-Vazquez, M.S., CCC-SLP

• Community/Behavioral Health Agency in Miami, FL
• Providers in Miami, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.