=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396690319
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPHERE HEALTH OF FLORIDA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2026
-----------------------------------------------------
Last Update Date | 03/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16690 COLLINS AVE STE 1102
-----------------------------------------------------
City | SUNNY ISLES BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33160-5687
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-310-1534
-----------------------------------------------------
Fax | 480-314-9494
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16690 COLLINS AVE STE 1102
-----------------------------------------------------
City | SUNNY ISLES BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33160-5687
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-310-1534
-----------------------------------------------------
Fax | 480-314-9494
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | RICHARD SHAPIRO
-----------------------------------------------------
Credential | CPA
-----------------------------------------------------
Telephone | 480-310-1534
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------