| Tamiami Community Center Llc | |
|
14255 Sw 42nd St Ste 13b Miami FL 33175-6408 | |
| (305) 821-1711 | |
| Not Available |
| Full Name | Tamiami Community Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 14255 Sw 42nd St Ste 13b, Miami, Florida |
| Authorized Official Name and Position | Olga Simon (MBR) |
| Authorized Official Contact | 3058211711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamiami Community Center Llc 14255 Sw 42nd St Ste 13b Miami FL 33175-6408 Ph: (305) 821-1711 | Tamiami Community Center Llc 14255 Sw 42nd St Ste 13b Miami FL 33175-6408 Ph: (305) 821-1711 |
| NPI Number | 1205456670 |
|---|---|
| Provider Enumeration Date | 04/25/2020 |
| Last Update Date | 04/25/2020 |
| Certification Date | 04/25/2020 |
| Medicare PECOS PAC ID | 9830585975 |
|---|---|
| Medicare Enrollment ID | O20220329003050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205456670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Vanessa L Pages |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659317782 PECOS PAC ID: 3072508654 Enrollment ID: I20081218000638 |
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