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General NPI Number Information
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NPI Number | 1760116966
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Entity Type | Organization
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Legal Business Name | FAMILY MENTAL HEALTH SERVICES OF SOUTH FLORIDA, LLC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 1533 SUNSET DR STE 225
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City | CORAL GABLES
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State | FL
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Zip | 33143-5700
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Country | US
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Telephone | 786-252-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 SUNSET HARBOR DR APT 706
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1478
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Country | US
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Telephone | 786-252-1665
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Fax |
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Authorized Official
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Title or Position | OWNER - AUTHORIZED OFFICIAL
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Name | MR. NICHOLAS MACHADO-FEUERMANN
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Credential | MBA
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Telephone | 786-252-1665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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