Healthcare Provider Details

I. General information

NPI: 1689982415
Provider Name (Legal Business Name): INFINITE BEHAVIORAL HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 HOLLYWOOD BLVD SUITE 1 AND 2
HOLLYWOOD FL
33020-6605
US

IV. Provider business mailing address

2421 HOLLYWOOD BLVD. SUITE 1 AND 2
HOLLYWOOD FL
33020-6711
US

V. Phone/Fax

Practice location:
  • Phone: 954-923-9111
  • Fax: 954-923-9190
Mailing address:
  • Phone: 954-309-5667
  • Fax: 305-935-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY7670
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberME63070
License Number StateFL

VIII. Authorized Official

Name: MS. NATALIE ALAZRACHI
Title or Position: VICE PRESIDENT
Credential: LMHC
Phone: 305-915-0551