Healthcare Provider Details

I. General information

NPI: 1144797838
Provider Name (Legal Business Name): FLORIDA PERSONAL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22133 S DIXIE HWY
MIAMI FL
33170-2840
US

IV. Provider business mailing address

13155 SW 134TH ST STE 202
MIAMI FL
33186-4488
US

V. Phone/Fax

Practice location:
  • Phone: 786-504-3119
  • Fax: 954-206-2835
Mailing address:
  • Phone: 786-504-3119
  • Fax: 954-206-2835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. PEDRO MENDOZA
Title or Position: ADMINISTRATOR
Credential:
Phone: 786-370-8761