Healthcare Provider Details

I. General information

NPI: 1851162770
Provider Name (Legal Business Name): PSYCHIATRY & PSYCHOTHERAPY OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 S RED RD STE 611
SOUTH MIAMI FL
33143-3649
US

IV. Provider business mailing address

6705 S RED RD STE 611
SOUTH MIAMI FL
33143-3649
US

V. Phone/Fax

Practice location:
  • Phone: 305-202-4768
  • Fax: 916-249-0695
Mailing address:
  • Phone: 305-202-4768
  • Fax: 916-249-0695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ESTEBAN CARDONNE
Title or Position: OWNER
Credential:
Phone: 305-202-4768