Healthcare Provider Details

I. General information

NPI: 1174292130
Provider Name (Legal Business Name): RATIONAL PSYCH CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2021
Last Update Date: 09/12/2021
Certification Date: 09/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 NW 53RD ST STE 337
MIAMI FL
33166-4791
US

IV. Provider business mailing address

7950 NW 53RD ST STE 337
MIAMI FL
33166-4791
US

V. Phone/Fax

Practice location:
  • Phone: 305-901-4344
  • Fax: 866-480-9591
Mailing address:
  • Phone: 305-901-4344
  • Fax: 866-480-9591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OCTAVIO MIGUEL ALFONSO
Title or Position: PRESIDENT
Credential: NURSE PRACTITIONER
Phone: 305-901-4344