Healthcare Provider Details

I. General information

NPI: 1285432385
Provider Name (Legal Business Name): MIAMI TARGERED CASE MANAGEMENT AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5409 SW 139TH CT
MIAMI FL
33175-6016
US

IV. Provider business mailing address

5409 SW 139TH CT
MIAMI FL
33175-6016
US

V. Phone/Fax

Practice location:
  • Phone: 305-984-4195
  • Fax:
Mailing address:
  • Phone: 305-984-4195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AILYN TORRES HORTA
Title or Position: OWNER
Credential: MSC
Phone: 786-608-3849