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General NPI Number Information
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NPI Number | 1306897954
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Entity Type | Organization
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Legal Business Name | OUTPATIENT PSY CARE INC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 3271 NW 7TH ST. SUITE # 203
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City | MIAMI
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State | FL
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Zip | 33125
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Country | US
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Telephone | 786-220-6902
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Fax | 866-726-0526
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Provider Business Mailing Address
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Address Line | PO BOX 347604
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City | CORAL GABLES
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State | FL
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Zip | 33234-7604
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Country | US
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Telephone | 305-984-8422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIVIAN D.J. GONZALEZ-DIAZ
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Credential | PH.D
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Telephone | 786-220-6902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY5395
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY5395
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License Number State | FL
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