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NPI Code Detail

MEDICARE: ADVANCED MENTAL HEALTH CLINIC INC

MEDICARE: ADVANCED MENTAL HEALTH CLINIC 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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1922774397
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED MENTAL HEALTH CLINIC INC
Provider Business Mailing Address
First Line : 13055 SW 42ND ST STE 104
Second Line :
City : MIAMI
State : FL
Zip : 33175-3470
Country : US
Telephone Number : 305-480-7839
Fax Number : 305-480-7892
Provider Business Practice Location Address
First Line : 13055 SW 42ND ST STE 104
Second Line :
City : MIAMI
State : FL
Zip : 33175-3470
Country : US
Telephone Number : 305-480-7839
Fax Number : 305-480-7892
Authorized Official
Title or Position : CEO
Name : LUCIA CARRENO
Credential :
Telephone Number : 305-480-7839
Provider Enumeration Date : 08/17/2021
Last Update Date : 08/17/2021

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