Healthcare Provider Details

I. General information

NPI: 1316613367
Provider Name (Legal Business Name): POSITIVE HEALTH PSYCHLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11385 SW 32ND ST
MIAMI FL
33165-2271
US

IV. Provider business mailing address

11385 SW 32ND ST
MIAMI FL
33165-2271
US

V. Phone/Fax

Practice location:
  • Phone: 786-567-8160
  • Fax: 954-212-8154
Mailing address:
  • Phone: 786-567-8160
  • Fax: 954-212-8154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SANDRA CASTILLO
Title or Position: CLINICAL DIRECTOR
Credential: PSYD
Phone: 305-342-6667