| Miami Psychiatric Services, Llc. | |
|
12260 Sw 8th St Suite 154 Miami FL 33184-1551 | |
| (786) 409-5503 | |
| (786) 452-1165 |
| Full Name | Miami Psychiatric Services, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 12260 Sw 8th St, Miami, Florida |
| Authorized Official Name and Position | Myuna Ruiz (MANAGER) |
| Authorized Official Contact | 7863559682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miami Psychiatric Services, Llc. 12260 Sw 8th St Suite 154 Miami FL 33184-1551 Ph: (786) 409-5503 | Miami Psychiatric Services, Llc. 12260 Sw 8th St Suite 154 Miami FL 33184-1551 Ph: (786) 409-5503 |
| NPI Number | 1043765605 |
|---|---|
| Provider Enumeration Date | 08/23/2016 |
| Last Update Date | 06/10/2022 |
| Certification Date | 06/10/2022 |
| Medicare PECOS PAC ID | 2062795909 |
|---|---|
| Medicare Enrollment ID | O20170220001205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043765605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | ME122666 (Florida) | Primary |
| Provider Name | Myuna Ruiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669737110 PECOS PAC ID: 4880977727 Enrollment ID: I20170220001284 |
| Provider Name | Alberto Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477857167 PECOS PAC ID: 3274696711 Enrollment ID: I20210729001243 |
| Provider Name | Mireisy Mesa Villalonga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093462467 PECOS PAC ID: 3779954938 Enrollment ID: I20230126000058 |
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