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General NPI Number Information
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NPI Number | 1164566683
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH SERVICES OF FLORIDA PA
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 7550 S RED RD 211
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5343
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Country | US
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Telephone | 305-667-8114
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Fax | 786-513-0143
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Provider Business Mailing Address
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Address Line | 7550 S RED RD 211
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5343
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Country | US
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Telephone | 305-667-8114
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Fax | 786-513-0143
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Authorized Official
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Title or Position | SUPERVISING PHYSICIAN
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Name | DR. SAJID LOPEZ
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Credential | M.D.
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Telephone | 305-667-8114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | ME7177
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License Number State | FL
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