| Novos Behavioral Health Center Inc | |
|
2103 Coral Way Ste 603 Miami FL 33145-2656 | |
| (786) 464-0353 | |
| (786) 483-8142 |
| Full Name | Novos Behavioral Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2103 Coral Way Ste 603, Miami, Florida |
| Authorized Official Name and Position | Josue Rodriguez (VICE PRESIDENT) |
| Authorized Official Contact | 7864513040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Novos Behavioral Health Center Inc 2103 Coral Way Ste 603 Miami FL 33145-2656 Ph: (786) 464-0353 | Novos Behavioral Health Center Inc 2103 Coral Way Ste 603 Miami FL 33145-2656 Ph: (786) 464-0353 |
| NPI Number | 1952931743 |
|---|---|
| Provider Enumeration Date | 01/21/2020 |
| Last Update Date | 06/27/2023 |
| Certification Date | 06/27/2023 |
| Medicare PECOS PAC ID | 9133544752 |
|---|---|
| Medicare Enrollment ID | O20200730000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952931743 | NPI | - | NPPES |
| 105357500 | Medicaid | FL | |
| 105925800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carlos A Ripoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558751099 PECOS PAC ID: 7214034404 Enrollment ID: I20151014001048 |
| Provider Name | Ludim E Herrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013493972 PECOS PAC ID: 5294168183 Enrollment ID: I20191206001765 |
| Provider Name | Ailyn Rodriguez Cambas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669878112 PECOS PAC ID: 7416305420 Enrollment ID: I20231201001588 |
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