Healthcare Provider Details
I. General information
NPI: 1548005333
Provider Name (Legal Business Name): BIOPSYCHODANCE MENTAL HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2024
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2010 NE 14TH ST STE 400
OCALA FL
34470-7740
US
IV. Provider business mailing address
2010 NE 14TH ST STE 400
OCALA FL
34470-7740
US
V. Phone/Fax
- Phone: 352-421-5635
- Fax: 352-421-9040
- Phone: 786-965-0671
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JACQUELINE
MARIA
ALVAREZ GARCIA
Title or Position: OWNER
Credential:
Phone: 786-965-0671