Healthcare Provider Details

I. General information

NPI: 1356932586
Provider Name (Legal Business Name): LA FAMILIA MENTAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2021
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 W 84TH ST STE 31
HIALEAH FL
33014-3355
US

IV. Provider business mailing address

1550 W 84TH ST STE 31
HIALEAH FL
33014-3355
US

V. Phone/Fax

Practice location:
  • Phone: 305-901-1191
  • Fax: 786-615-5635
Mailing address:
  • Phone: 305-742-5163
  • Fax: 786-615-5635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISIS MASSON
Title or Position: OWNER
Credential:
Phone: 305-901-1191