| Vita-cog Communith Health, Llc | |
|
9220 Sunset Dr Ste 104 Miami FL 33173-3259 | |
| (786) 724-4224 | |
| (305) 397-2285 |
| Full Name | Vita-cog Communith Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9220 Sunset Dr Ste 104, Miami, Florida |
| Authorized Official Name and Position | Daema Pina Delgado (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7867244224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vita-cog Communith Health, Llc 9220 Sunset Dr Ste 104 Miami FL 33173-3259 Ph: (786) 724-4224 | Vita-cog Communith Health, Llc 9220 Sunset Dr Ste 104 Miami FL 33173-3259 Ph: (786) 724-4224 |
| NPI Number | 1720658677 |
|---|---|
| Provider Enumeration Date | 07/01/2021 |
| Last Update Date | 08/24/2024 |
| Certification Date | 08/24/2024 |
| Medicare PECOS PAC ID | 2062806094 |
|---|---|
| Medicare Enrollment ID | O20220308001253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720658677 | NPI | - | NPPES |
| Provider Name | Sarah Ruth Banka Barron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770874067 PECOS PAC ID: 6002129012 Enrollment ID: I20150721000158 |
| Provider Name | Christopher Edouard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679028856 PECOS PAC ID: 3173894326 Enrollment ID: I20170805000293 |
| Provider Name | Daema Pina Delgado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194234971 PECOS PAC ID: 9739427816 Enrollment ID: I20190214003049 |
| Provider Name | Anasuya Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477018182 PECOS PAC ID: 2062745680 Enrollment ID: I20190612002950 |
| Provider Name | Andrea Beatriz De Aguayo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730601048 PECOS PAC ID: 4082014766 Enrollment ID: I20210617000971 |
| Provider Name | Annemarie Morales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184288771 PECOS PAC ID: 7315332780 Enrollment ID: I20220322000771 |
| Provider Name | Melissa Garcia-martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942738950 PECOS PAC ID: 0648665935 Enrollment ID: I20220323002862 |
| Provider Name | Monica Estupinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457034217 PECOS PAC ID: 7315391133 Enrollment ID: I20230928000232 |
| Provider Name | Tenisha Pettus |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376175026 PECOS PAC ID: 4486004785 Enrollment ID: I20231228003515 |
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