Healthcare Provider Details

I. General information

NPI: 1871409979
Provider Name (Legal Business Name): CARRASQUERO PINEDA SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15069 SW 117TH WAY
MIAMI FL
33196-6820
US

IV. Provider business mailing address

15069 SW 117TH WAY
MIAMI FL
33196-6820
US

V. Phone/Fax

Practice location:
  • Phone: 786-516-0476
  • Fax:
Mailing address:
  • Phone: 786-516-0476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MAYSA V PINEDA
Title or Position: DIRECTOR
Credential: LMHC
Phone: 786-516-0476