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General NPI Number Information
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NPI Number | 1699167403
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH INSTITUTE OF FLORIDA
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1921 NW 150TH AVE STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2872
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Country | US
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Telephone | 786-393-0361
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Fax | 954-251-7005
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Provider Business Mailing Address
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Address Line | 3311 SW 195TH TER
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City | MIRAMAR
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State | FL
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Zip | 33029-5881
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Country | US
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Telephone | 954-663-8086
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Fax | 954-251-7005
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. ANDRES FELICIANO MAMBUCA
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Credential | PSYD, MS, LMHC, BCBA
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Telephone | 954-663-8086
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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 | MH11089
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | MH11089
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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