Professional Behavioral & Mental Health Inc | |
11780 Sw 89th St Ste 204 Miami FL 33186-2181 | |
(786) 587-7449 | |
Not Available |
Full Name | Professional Behavioral & Mental Health Inc |
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Speciality | Community/Behavioral Health |
Location | 11780 Sw 89th St Ste 204, Miami, Florida |
Authorized Official Name and Position | Juan R Reyes (PRESIDENT) |
Authorized Official Contact | 7865877449 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Professional Behavioral & Mental Health Inc 11780 Sw 89th St Ste 204 Miami FL 33186-2181 Ph: (786) 587-7449 | Professional Behavioral & Mental Health Inc 11780 Sw 89th St Ste 204 Miami FL 33186-2181 Ph: (786) 587-7449 |
NPI Number | 1295376960 |
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Provider Enumeration Date | 10/03/2019 |
Last Update Date | 04/06/2023 |
Certification Date | 04/06/2023 |
Medicare PECOS PAC ID | 2769801224 |
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Medicare Enrollment ID | O20201001002880 |
Identifier | Type | State | Issuer |
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1295376960 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Derrick H Diaz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629568340 PECOS PAC ID: 5294089447 Enrollment ID: I20181107001095 |
Provider Name | Elizabeth Dianne Potter |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1942691720 PECOS PAC ID: 5294077681 Enrollment ID: I20190506000949 |
Provider Name | Mayelin Morales |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1790220911 PECOS PAC ID: 4688067648 Enrollment ID: I20220215002658 |
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