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General NPI Number Information
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NPI Number | 1174055289
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH CENTER OF SOUTH FLORIDA, LLC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 3761 NE 10TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-5690
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Country | US
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Telephone | 305-510-7381
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Fax | 305-351-8882
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Provider Business Mailing Address
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Address Line | 3761 NE 10TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-5690
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Country | US
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Telephone | 305-510-7381
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Fax | 305-351-8882
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MARDIA RAMOS
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Credential | LMHC
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Telephone | 305-510-7381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | IMH15781
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | IMH13783
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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