Healthcare Provider Details

I. General information

NPI: 1134833163
Provider Name (Legal Business Name): R & C PSYCHIATRY AND INTEGRATIVE MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 PINES BLVD STE 150
PEMBROKE PINES FL
33024-6400
US

IV. Provider business mailing address

9050 PINES BLVD STE 150
PEMBROKE PINES FL
33024-6400
US

V. Phone/Fax

Practice location:
  • Phone: 305-915-4565
  • Fax: 954-256-6047
Mailing address:
  • Phone: 305-915-4565
  • Fax: 954-256-6047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBERTO CARMONA
Title or Position: OWNER
Credential:
Phone: 786-741-7792