| Campos Mental Health Center Corp | |
|
1490 W 49th Pl Ste 301 Hialeah FL 33012-8131 | |
| (305) 776-9499 | |
| Not Available |
| Full Name | Campos Mental Health Center Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 1490 W 49th Pl Ste 301, Hialeah, Florida |
| Authorized Official Name and Position | Jorge Rodriguez Campo (PRESIDENT) |
| Authorized Official Contact | 3057769499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Campos Mental Health Center Corp 1490 W 49th Pl Ste 301 Hialeah FL 33012-8131 Ph: (305) 776-9499 | Campos Mental Health Center Corp 1490 W 49th Pl Ste 301 Hialeah FL 33012-8131 Ph: (305) 776-9499 |
| NPI Number | 1699472274 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 07/26/2024 |
| Medicare PECOS PAC ID | 3072960343 |
|---|---|
| Medicare Enrollment ID | O20231108000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699472274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Alireza Shams |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215323183 PECOS PAC ID: 3870895253 Enrollment ID: I20201022000141 |
| Provider Name | Michelle Reichard Stubbe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003450289 PECOS PAC ID: 8820415052 Enrollment ID: I20231130000156 |
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