| Advance Mental Health Community | |
|
640 W Palm Dr Ste D Florida City FL 33034-3237 | |
| (786) 610-8167 | |
| Not Available |
| Full Name | Advance Mental Health Community |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 640 W Palm Dr Ste D, Florida City, Florida |
| Authorized Official Name and Position | Annia M Perez (PRESIDENT) |
| Authorized Official Contact | 7866108167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advance Mental Health Community 640 W Palm Dr Ste D Florida City FL 33034-3237 Ph: (786) 610-8167 | Advance Mental Health Community 640 W Palm Dr Ste D Florida City FL 33034-3237 Ph: (786) 610-8167 |
| NPI Number | 1093272296 |
|---|---|
| Provider Enumeration Date | 02/23/2019 |
| Last Update Date | 10/24/2024 |
| Certification Date | 10/24/2024 |
| Medicare PECOS PAC ID | 2466857305 |
|---|---|
| Medicare Enrollment ID | O20210816003001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093272296 | NPI | - | NPPES |
| Provider Name | Fabio Mariano Mehrgut |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174504690 PECOS PAC ID: 7012337348 Enrollment ID: I20201026001463 |
| Provider Name | Liliam Rivero Fundora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609486943 PECOS PAC ID: 3274994462 Enrollment ID: I20230803004257 |
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