Healthcare Provider Details

I. General information

NPI: 1871961805
Provider Name (Legal Business Name): CARPE DIEM ACADEMY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11025 SW 84TH ST COTTAGE 8
MIAMI FL
33173-3857
US

IV. Provider business mailing address

11025 SW 84TH ST COTTAGE 8
MIAMI FL
33173-3857
US

V. Phone/Fax

Practice location:
  • Phone: 786-395-4900
  • Fax: 305-971-3095
Mailing address:
  • Phone: 786-395-4900
  • Fax: 305-971-3095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LISSA TORRES
Title or Position: PRESIDENT
Credential:
Phone: 786-395-4900