Healthcare Provider Details

I. General information

NPI: 1932522935
Provider Name (Legal Business Name): CARPE DIEM ACADEMY LITTLE HAVANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 SW 1ST ST
MIAMI FL
33135-1602
US

IV. Provider business mailing address

2095 SW 1ST ST
MIAMI FL
33135-1602
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-9800
  • Fax: 305-642-9229
Mailing address:
  • Phone: 305-642-9800
  • Fax: 305-642-9229

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 Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1181712
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
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