Healthcare Provider Details

I. General information

NPI: 1447403290
Provider Name (Legal Business Name): CENTER FOR BEHAVIORAL HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10250 SW 56TH ST STE A102
MIAMI FL
33165-7064
US

IV. Provider business mailing address

10250 SW 56TH ST STE A102
MIAMI FL
33165-7064
US

V. Phone/Fax

Practice location:
  • Phone: 786-477-4431
  • Fax: 786-477-4377
Mailing address:
  • Phone: 786-477-4431
  • Fax: 786-477-4377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME102626
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MANUEL A MELENDEZ
Title or Position: MEMBER
Credential: MD
Phone: 786-477-4431