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10300 Sw 72nd St Ste 272-1 Miami FL 33173-3032 | |
| (206) 929-6200 | |
| (206) 279-7300 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 10300 Sw 72nd St Ste 272-1, Miami, Florida |
| Authorized Official Name and Position | Roberto Hernandez (PRESIDENT) |
| Authorized Official Contact | 3054970272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10051 Sw 46th St Miami FL 33165-5709 Ph: (305) 497-0272 | 10300 Sw 72nd St Ste 272-1 Miami FL 33173-3032 Ph: (206) 929-6200 |
| NPI Number | 1952009375 |
|---|---|
| Provider Enumeration Date | 02/16/2023 |
| Last Update Date | 02/03/2025 |
| Certification Date | 02/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952009375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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