Healthcare Provider Details

I. General information

NPI: 1821774126
Provider Name (Legal Business Name): OCEAN REEF MEDICAL INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4471 NW 36TH ST STE 230
MIAMI SPRINGS FL
33166-7289
US

IV. Provider business mailing address

1138 W 41ST ST
HIALEAH FL
33012-4167
US

V. Phone/Fax

Practice location:
  • Phone: 786-859-1918
  • Fax:
Mailing address:
  • Phone: 786-859-1918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARIA AMANDA TREJOS
Title or Position: OWNER/ MANAGER
Credential:
Phone: 786-859-1918