Healthcare Provider Details

I. General information

NPI: 1487592838
Provider Name (Legal Business Name): ELEVATED HEALTH NETWORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 SW 37TH AVE STE 101
MIAMI FL
33133-2744
US

IV. Provider business mailing address

2645 SW 37TH AVE STE 101
MIAMI FL
33133-2744
US

V. Phone/Fax

Practice location:
  • Phone: 786-530-4080
  • Fax:
Mailing address:
  • Phone: 786-530-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GERARDO RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-506-5219