MEDICARE: ALL DADE 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

General Provider Information

NPI Number	:	1578679940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL DADE MENTAL SERVICES INC

Provider Business Mailing Address
First Line	:	5143 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2442
Country	:	US
Telephone Number	:	305-569-0039
Fax Number	:

Provider Business Practice Location Address
First Line	:	5143 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2442
Country	:	US
Telephone Number	:	305-569-0039
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GUSTAVO A SMITH
Credential	:
Telephone Number	:	305-479-8501

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	08/22/2020

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Directions to “ALL DADE MENTAL SERVICES INC ” Practice Location

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