MEDICARE: MIAMI BEHAVIORAL HEALTH CENTER 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	1113AD777700	FL
2	101Y00000X	Counselor
3	1041C0700X	Clinical Social Worker
4	104100000X	Social Worker
5	106H00000X	Marriage & Family Therapist
6	2080A0000X	Pediatric Adolescent Medicine Physician
7	2084P0800X	Psychiatry Physician
8	2084P0804X	Child & Adolescent Psychiatry Physician
9	101YA0400X	Addiction (Substance Use Disorder) Counselor
10	164W00000X	Licensed Practical Nurse
11	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
12	163W00000X	Registered Nurse
13	376J00000X	Homemaker
14	207Q00000X	Family Medicine Physician
15	101YM0800X	Mental Health Counselor	1113AD777700	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457319451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI BEHAVIORAL HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	6100 BLUE LAGOON DR
Second Line	:	SUITE400
City	:	MIAMI
State	:	FL
Zip	:	33126-2079
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:	305-757-2387

Provider Business Practice Location Address
First Line	:	3850 W FLAGLER ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1604
Country	:	US
Telephone Number	:	305-774-3300
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ILEANA RUIZ GARCIA
Credential	:	MSW
Telephone Number	:	305-398-6100

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	10/07/2015

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Directions to “MIAMI BEHAVIORAL HEALTH CENTER INC ” Practice Location

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