Healthcare Provider Details

I. General information

NPI: 1215639448
Provider Name (Legal Business Name): KENDALL PSYCHIATRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 SW 88TH ST STE 200
MIAMI FL
33176-0938
US

IV. Provider business mailing address

7604 SW 139TH CT
MIAMI FL
33183-3083
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-2343
  • Fax:
Mailing address:
  • Phone: 305-326-6550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: SANDRA ROSENBERG
Title or Position: OWNER
Credential: FNP,PMHNP
Phone: 305-326-6550