| Mosaico Mental Health Center Corp | |
|
7726 Winegard Rd, 2nd Floor Ste 9 Orlando FL 32809-7147 | |
| (407) 930-0050 | |
| (407) 751-4804 |
| Full Name | Mosaico Mental Health Center Corp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7726 Winegard Rd, 2nd Floor Ste 9, Orlando, Florida |
| Authorized Official Name and Position | Iris Soto (ADMIN) |
| Authorized Official Contact | 4079300050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaico Mental Health Center Corp 7726 Winegard Rd, 2nd Floor Ste 9 Orlando FL 32809-7147 Ph: (407) 930-0050 | Mosaico Mental Health Center Corp 7726 Winegard Rd, 2nd Floor Ste 9 Orlando FL 32809-7147 Ph: (407) 930-0050 |
| NPI Number | 1114575636 |
|---|---|
| Provider Enumeration Date | 08/28/2019 |
| Last Update Date | 02/17/2022 |
| Certification Date | 02/17/2022 |
| Medicare PECOS PAC ID | 0042649782 |
|---|---|
| Medicare Enrollment ID | O20200401002016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114575636 | NPI | - | NPPES |
| 106075100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Gustavo V Ruiz Santiago |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598755761 PECOS PAC ID: 0749340560 Enrollment ID: I20160706000487 |
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