| Consalud Community Mental Health Llc | |
|
4160 W 16th Ave Ste 503 Hialeah FL 33012-5884 | |
| (786) 278-1882 | |
| Not Available |
| Full Name | Consalud Community Mental Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4160 W 16th Ave Ste 503, Hialeah, Florida |
| Authorized Official Name and Position | Carlos Hurtado (OWNER) |
| Authorized Official Contact | 7862781882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Consalud Community Mental Health Llc 4160 W 16th Ave Ste 503 Hialeah FL 33012-5884 Ph: () - | Consalud Community Mental Health Llc 4160 W 16th Ave Ste 503 Hialeah FL 33012-5884 Ph: (786) 278-1882 |
| NPI Number | 1912597840 |
|---|---|
| Provider Enumeration Date | 01/25/2021 |
| Last Update Date | 05/31/2022 |
| Certification Date | 05/31/2022 |
| Medicare PECOS PAC ID | 4789062670 |
|---|---|
| Medicare Enrollment ID | O20220606001272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912597840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carlos Alberto Hurtado Infante |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326357286 PECOS PAC ID: 3779705132 Enrollment ID: I20141124001571 |
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