| Advanced Mental Health Clinic Inc | |
|
13055 Sw 42nd St Ste 104 Miami FL 33175-3470 | |
| (305) 480-7839 | |
| (305) 480-7892 |
| Full Name | Advanced Mental Health Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13055 Sw 42nd St Ste 104, Miami, Florida |
| Authorized Official Name and Position | Lucia Carreno (PRESIDENT/ADMINISTRATOR) |
| Authorized Official Contact | 3054807839 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Mental Health Clinic Inc 13055 Sw 42nd St Ste 104 Miami FL 33175-3470 Ph: () - | Advanced Mental Health Clinic Inc 13055 Sw 42nd St Ste 104 Miami FL 33175-3470 Ph: (305) 480-7839 |
| NPI Number | 1285676494 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 09/01/2020 |
| Certification Date | 09/01/2020 |
| Medicare PECOS PAC ID | 7911924048 |
|---|---|
| Medicare Enrollment ID | O20110308000345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285676494 | NPI | - | NPPES |
| EO918A | Other | FL | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 101490 (Florida) | Primary |
| Provider Name | Natacha Martinez Padrino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427237528 PECOS PAC ID: 2961418728 Enrollment ID: I20060303000152 |
| Provider Name | Alexandra Yvette Mas |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881961332 PECOS PAC ID: 3870937626 Enrollment ID: I20240220002360 |
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