Healthcare Provider Details

I. General information

NPI: 1588720965
Provider Name (Legal Business Name): DOUGLAS GARDENS CMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 LINCOLN RD SUITE 200
MIAMI BEACH FL
33139-2879
US

IV. Provider business mailing address

701 LINCOLN RD SUITE 200
MIAMI BEACH FL
33139-2879
US

V. Phone/Fax

Practice location:
  • Phone: 305-531-5341
  • Fax: 305-532-5322
Mailing address:
  • Phone: 305-531-5341
  • Fax: 305-532-5322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL T. BRADY
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 305-531-5341