MEDICARE: IN THE MIDDLE THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1881410058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN THE MIDDLE THERAPY LLC

Provider Business Mailing Address
First Line	:	701 SE 8TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5619
Country	:	US
Telephone Number	:	305-528-1256
Fax Number	:	305-705-3236

Provider Business Practice Location Address
First Line	:	701 SE 8TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5619
Country	:	US
Telephone Number	:	305-528-1256
Fax Number	:	305-705-3236

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	CHRISTIAN SEBASTIAN SANTOS
Credential	:	LMCH
Telephone Number	:	305-528-1256

Provider Enumeration Date	:	12/03/2024
Last Update Date	:	12/03/2024

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