Healthcare Provider Details

I. General information

NPI: 1568239622
Provider Name (Legal Business Name): PSYCHEMEND FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8870 SW 92ND CT
MIAMI FL
33176-2008
US

IV. Provider business mailing address

8870 SW 92ND CT
MIAMI FL
33176-2008
US

V. Phone/Fax

Practice location:
  • Phone: 786-247-2717
  • Fax: 786-221-3853
Mailing address:
  • Phone: 786-247-2717
  • Fax: 786-221-3853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEJANDRO PEREZ
Title or Position: PRESIDENT
Credential: RN
Phone: 786-247-2717