Healthcare Provider Details

I. General information

NPI: 1679686588
Provider Name (Legal Business Name): PALMETTO ASSOCIATES CMHC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 8TH ST SUITE 101A
MIAMI FL
33144-4400
US

IV. Provider business mailing address

7500 SW 8TH ST SUITE 101A
MIAMI FL
33144-4400
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-9400
  • Fax:
Mailing address:
  • Phone: 305-262-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number101476
License Number StateFL

VIII. Authorized Official

Name: MISS AMPARO FARINAS COLLAZO
Title or Position: PRESIDENT
Credential:
Phone: 305-262-9400