MEDICARE: MEDICAL & MENTAL SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1184488447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL & MENTAL SERVICES INC

Provider Business Mailing Address
First Line	:	777 E 25TH ST STE 507
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3834
Country	:	US
Telephone Number	:	786-683-1865
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 E 25TH ST
Second Line	:	SUITE 212
City	:	HIALEAH
State	:	FL
Zip	:	33013-3834
Country	:	US
Telephone Number	:	786-683-1865
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HODELIN AQUINO GOMEZ
Credential	:
Telephone Number	:	786-683-1865

Provider Enumeration Date	:	02/07/2024
Last Update Date	:	05/11/2026

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Directions to “MEDICAL & MENTAL SERVICES INC ” Practice Location

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