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2828 Coral Way Ste 460 Coral Gables FL 33145-3242 | |
| (305) 642-5255 | |
| (305) 642-8850 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2828 Coral Way Ste 460, Coral Gables, Florida |
| Authorized Official Name and Position | Luis C Hines (CEO) |
| Authorized Official Contact | 3056425255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2828 Coral Way Ste 460 Coral Gables FL 33145-3242 Ph: (305) 642-5255 | 2828 Coral Way Ste 460 Coral Gables FL 33145-3242 Ph: (305) 642-5255 |
| NPI Number | 1558357475 |
|---|---|
| Provider Enumeration Date | 09/26/2005 |
| Last Update Date | 12/11/2023 |
| Certification Date | 12/11/2023 |
| Medicare PECOS PAC ID | 1153311766 |
|---|---|
| Medicare Enrollment ID | O20040515000271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558357475 | NPI | - | NPPES |
| Provider Name | David R Kramer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376685354 PECOS PAC ID: 9537233143 Enrollment ID: I20080730000757 |
| Provider Name | Charles W Lester |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609981117 PECOS PAC ID: 6709196645 Enrollment ID: I20151105001808 |
| Provider Name | Marie Rose S Jasmin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336544733 PECOS PAC ID: 6103146840 Enrollment ID: I20160323000466 |
| Provider Name | Boby Ukken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447656244 PECOS PAC ID: 7911258892 Enrollment ID: I20180918000470 |
| Provider Name | Agnes A Narikkattu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235535030 PECOS PAC ID: 3779956602 Enrollment ID: I20230223002998 |
| Provider Name | Cindy Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902298433 PECOS PAC ID: 7517339229 Enrollment ID: I20230824002228 |
| Provider Name | Nandi R Dillard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538846142 PECOS PAC ID: 9335682020 Enrollment ID: I20240622000532 |
| Provider Name | Luis C Hines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609865237 PECOS PAC ID: 5698765212 Enrollment ID: I20240625001832 |
| Provider Name | Wendy Cabrera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801187273 PECOS PAC ID: 7911442256 Enrollment ID: I20240711001421 |
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