Healthcare Provider Details

I. General information

NPI: 1386552370
Provider Name (Legal Business Name): HAVEN PROVIDERS MENTAL HEALTH.LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1039 NE 3RD AVE
HOMESTEAD FL
33030-4718
US

IV. Provider business mailing address

1039 NE 3RD AVE
HOMESTEAD FL
33030-4718
US

V. Phone/Fax

Practice location:
  • Phone: 786-641-8364
  • Fax:
Mailing address:
  • Phone: 786-641-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AILEN ROJAS GARCIA
Title or Position: OWNER
Credential: PMHNP
Phone: 786-641-8364