| Behavioral Momentum Of Miami | |
|
10561 Sw 122nd Ct Miami FL 33186-3632 | |
| (305) 775-2489 | |
| Not Available |
| Full Name | Behavioral Momentum Of Miami |
|---|---|
| Speciality | Social Worker |
| Location | 10561 Sw 122nd Ct, Miami, Florida |
| Authorized Official Name and Position | Maykel Raul Mateo (PRESIDENT) |
| Authorized Official Contact | 7863901855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Momentum Of Miami 10561 Sw 122nd Ct Miami FL 33186-3632 Ph: (305) 775-2489 | Behavioral Momentum Of Miami 10561 Sw 122nd Ct Miami FL 33186-3632 Ph: (305) 775-2489 |
| NPI Number | 1164914172 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 10/21/2021 |
| Certification Date | 10/21/2021 |
| Medicare PECOS PAC ID | 9133454010 |
|---|---|
| Medicare Enrollment ID | O20190715002671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164914172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cornelia E Mayor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952661613 PECOS PAC ID: 4981992583 Enrollment ID: I20161014000862 |
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