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General NPI Number Information
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NPI Number | 1710728878
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Entity Type | Organization
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Legal Business Name | ABRAX HEALTH INSTITUTE LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1810 W 56TH ST APT 3221
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City | HIALEAH
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State | FL
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Zip | 33012-7378
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Country | US
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Telephone | 561-724-7387
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 W 56TH ST APT 3221
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City | HIALEAH
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State | FL
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Zip | 33012-7378
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Country | US
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Telephone | 561-724-7387
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Fax |
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Authorized Official
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Title or Position | CEO, PRESIDENT
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Name | MARCOS J CARVAJAL BERMEJO
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Credential | DNP, PMHNP-BC, APRN
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Telephone | 561-724-7387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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