Healthcare Provider Details

I. General information

NPI: 1457297897
Provider Name (Legal Business Name): HERZA BEHAVIORAL & MEDICAL SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16633 SW 47TH ST
MIAMI FL
33185-5277
US

IV. Provider business mailing address

16633 SW 47TH ST
MIAMI FL
33185-5277
US

V. Phone/Fax

Practice location:
  • Phone: 305-926-2581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ABEY HERNANDEZ MARIN
Title or Position: NURSE PRACTITIONER
Credential: APRN, PMHNP-BC, FNP-
Phone: 305-926-2581