MEDICARE: SUMMERSKYY HEALTH, LLC

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1952009375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMERSKYY HEALTH, LLC

Provider Business Mailing Address
First Line	:	10051 SW 46TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5709
Country	:	US
Telephone Number	:	305-497-0272
Fax Number	:

Provider Business Practice Location Address
First Line	:	10300 SW 72ND ST STE 272-1
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3032
Country	:	US
Telephone Number	:	206-929-6200
Fax Number	:	206-279-7300

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERTO HERNANDEZ
Credential	:
Telephone Number	:	305-497-0272

Provider Enumeration Date	:	02/16/2023
Last Update Date	:	02/03/2025

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Directions to “SUMMERSKYY HEALTH, LLC ” Practice Location

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