Healthcare Provider Details

I. General information

NPI: 1497348015
Provider Name (Legal Business Name): HARMONY MENTAL HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W 76TH ST STE 312
HIALEAH FL
33016-5500
US

IV. Provider business mailing address

2100 W 76TH ST STE 312
HIALEAH FL
33016-5500
US

V. Phone/Fax

Practice location:
  • Phone: 786-598-7621
  • Fax:
Mailing address:
  • Phone: 786-598-7621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ROXANA RODRIGUEZ
Title or Position: PRESIDENT
Credential: APRN
Phone: 786-598-7621