| La Luz Mental Health Services Inc | |
|
12700 Sw 128th St Ste 108 Miami FL 33186-5378 | |
| (786) 732-0865 | |
| (786) 732-0972 |
| Full Name | La Luz Mental Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12700 Sw 128th St Ste 108, Miami, Florida |
| Authorized Official Name and Position | Jacqueline Galan (CEO) |
| Authorized Official Contact | 3055824807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Luz Mental Health Services Inc 3402 Sw 89th Ave Miami FL 33165-4238 Ph: (305) 582-4807 | La Luz Mental Health Services Inc 12700 Sw 128th St Ste 108 Miami FL 33186-5378 Ph: (786) 732-0865 |
| NPI Number | 1538746524 |
|---|---|
| Provider Enumeration Date | 03/25/2021 |
| Last Update Date | 11/17/2023 |
| Medicare PECOS PAC ID | 4183002546 |
|---|---|
| Medicare Enrollment ID | O20220526001043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538746524 | NPI | - | NPPES |
| Provider Name | Oghenevwogaga Ophori |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1740570118 PECOS PAC ID: 8729398508 Enrollment ID: I20151106000541 |
| Provider Name | Iraida Pozo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972918795 PECOS PAC ID: 4789034869 Enrollment ID: I20240102002771 |
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