| Clementine Palmetto Bay | |
|
7201 Sw 174th St Palmetto Bay FL 33157-6304 | |
| (786) 809-3600 | |
| (305) 235-4331 |
| Full Name | Clementine Palmetto Bay |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 7201 Sw 174th St, Palmetto Bay, Florida |
| Authorized Official Name and Position | Mike Bagley (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3056631876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clementine Palmetto Bay 6100 Sw 76th St South Miami FL 33143-5002 Ph: (305) 663-1876 | Clementine Palmetto Bay 7201 Sw 174th St Palmetto Bay FL 33157-6304 Ph: (786) 809-3600 |
| NPI Number | 1154589687 |
|---|---|
| Provider Enumeration Date | 05/31/2008 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154589687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (Florida) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (Florida) | Primary |
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