Healthcare Provider Details

I. General information

NPI: 1245836584
Provider Name (Legal Business Name): SOCRA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BELVEDERE RD STE E300-11
WEST PALM BEACH FL
33406-1541
US

IV. Provider business mailing address

1601 BELVEDERE RD STE 300E
WEST PALM BEACH FL
33406-1554
US

V. Phone/Fax

Practice location:
  • Phone: 786-828-4884
  • Fax: 561-568-7278
Mailing address:
  • Phone: 786-828-4884
  • Fax: 561-568-7278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: RAIZA JIMENEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-828-4884