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NPI Code Detail

MEDICARE: BENWELL REALITY HEALTH CENTER

MEDICARE: BENWELL REALITY HEALTH CENTER
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
1103TF0000XFamily Psychologist
2103TP2701XGroup Psychotherapy Psychologist
3251S00000XCommunity/Behavioral Health Agency
4261QC1500XCommunity Health Clinic/Center
5261QP2300XPrimary Care Clinic/Center
6320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7261QH0100XHealth Service Clinic/Center
8261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
9103TA0700XAdult Development & Aging Psychologist
10261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1861388274
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENWELL REALITY HEALTH CENTER
Provider Business Mailing Address
First Line : 7900 NW 27TH AVE STE B03
Second Line :
City : MIAMI
State : FL
Zip : 33147-4910
Country : US
Telephone Number : 305-771-4544
Fax Number :
Provider Business Practice Location Address
First Line : 7900 NW 27TH AVE STE B03
Second Line :
City : MIAMI
State : FL
Zip : 33147-4910
Country : US
Telephone Number : 305-771-4544
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : ILNISE MATHIEU
Credential :
Telephone Number : 305-771-4544
Provider Enumeration Date : 06/13/2025
Last Update Date : 06/13/2025

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Directions to “BENWELL REALITY HEALTH CENTER ” Practice Location

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