Healthcare Provider Details

I. General information

NPI: 1467047597
Provider Name (Legal Business Name): AAA MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 NW 54TH ST
MIAMI FL
33127-1920
US

IV. Provider business mailing address

310 NW 54TH ST
MIAMI FL
33127-1920
US

V. Phone/Fax

Practice location:
  • Phone: 305-992-4008
  • Fax:
Mailing address:
  • Phone: 305-992-4008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANA AZCUY
Title or Position: PRESIDENT
Credential:
Phone: 786-413-9995