=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336644780
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAMI MIAMI-DADE COUNTY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2018
-----------------------------------------------------
Last Update Date | 03/28/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 299 ALHAMBRA CIR STE 224
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-5116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-665-2540
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 299 ALHAMBRA CIR STE 224
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-5116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-665-2540
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | KATHRYN ANN COPPOLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-665-2540
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------