Healthcare Provider Details

I. General information

NPI: 1184488447
Provider Name (Legal Business Name): MEDICAL & MENTAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST SUITE 212
HIALEAH FL
33013-3834
US

IV. Provider business mailing address

777 E 25TH ST STE 507
HIALEAH FL
33013-3834
US

V. Phone/Fax

Practice location:
  • Phone: 786-683-1865
  • Fax:
Mailing address:
  • Phone: 786-683-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HODELIN AQUINO GOMEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-683-1865