Healthcare Provider Details

I. General information

NPI: 1790590636
Provider Name (Legal Business Name): PINNACLE PSYCHIATRY SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 NW 104TH AVE UNIT A103
DORAL FL
33178-3375
US

IV. Provider business mailing address

10460 NW 74TH ST UNIT 101
DORAL FL
33178-2465
US

V. Phone/Fax

Practice location:
  • Phone: 786-877-3767
  • Fax:
Mailing address:
  • Phone: 786-877-3767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN DIEGO TAPIA
Title or Position: OWNER/CEO/PMHNP
Credential: PMHNP-BC
Phone: 786-877-3767