Healthcare Provider Details

I. General information

NPI: 1316792062
Provider Name (Legal Business Name): FLORIDA MENTAL HEALTH SOLUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23257 STATE ROAD 7 STE 204
BOCA RATON FL
33428-5406
US

IV. Provider business mailing address

23257 STATE ROAD 7 STE 204
BOCA RATON FL
33428-5406
US

V. Phone/Fax

Practice location:
  • Phone: 954-336-4440
  • Fax: 954-827-5706
Mailing address:
  • Phone: 954-336-4440
  • Fax: 954-827-5706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HENRI COIZEAU
Title or Position: PRESIDENT
Credential: LMHC
Phone: 954-336-4440