| Lago Mental Health Corp | |
|
11055 Sw 186th St Ste 2017 Cutler Bay FL 33157-6840 | |
| (786) 483-5523 | |
| Not Available |
| Full Name | Lago Mental Health Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 11055 Sw 186th St Ste 2017, Cutler Bay, Florida |
| Authorized Official Name and Position | Adlay Lago Jr (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7865348408 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lago Mental Health Corp 11055 Sw 186th St Ste 2017 Cutler Bay FL 33157-6840 Ph: () - | Lago Mental Health Corp 11055 Sw 186th St Ste 2017 Cutler Bay FL 33157-6840 Ph: (786) 483-5523 |
| NPI Number | 1356000640 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 12/14/2021 |
| Medicare PECOS PAC ID | 3577955491 |
|---|---|
| Medicare Enrollment ID | O20220126000930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356000640 | NPI | - | NPPES |
| 110058400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ricardo A Neira |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215078639 PECOS PAC ID: 3971797952 Enrollment ID: I20101103001071 |
| Provider Name | Gabriel Betancourt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497001663 PECOS PAC ID: 4183849672 Enrollment ID: I20140625000579 |
| Provider Name | Gloria M Grajales |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043522691 PECOS PAC ID: 1456646975 Enrollment ID: I20160823002582 |
| Provider Name | Erick Paulino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144927146 PECOS PAC ID: 1557726007 Enrollment ID: I20230505000437 |
| Provider Name | Maria Del Pilar Ara Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740924356 PECOS PAC ID: 4385009760 Enrollment ID: I20230509000690 |
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