Healthcare Provider Details

I. General information

NPI: 1952009375
Provider Name (Legal Business Name): SUMMERSKYY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST STE 272-1
MIAMI FL
33173-3032
US

IV. Provider business mailing address

10051 SW 46TH ST
MIAMI FL
33165-5709
US

V. Phone/Fax

Practice location:
  • Phone: 206-929-6200
  • Fax: 206-279-7300
Mailing address:
  • Phone: 305-497-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERTO HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-497-0272