Healthcare Provider Details

I. General information

NPI: 1316304488
Provider Name (Legal Business Name): BERMUDEZ BEHAVIORAL AND MENTAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 01/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3442 WILSHIRE WAY RD
ORLANDO FL
32829-7354
US

IV. Provider business mailing address

3442 WILSHIRE WAY RD
ORLANDO FL
32829-7354
US

V. Phone/Fax

Practice location:
  • Phone: 305-767-8223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ANGEL ADRIAN PEREZ BERMUDEZ
Title or Position: FOUNDER
Credential: MHS
Phone: 305-767-8223