Provider Demographics
NPI:1174055289
Name:MENTAL HEALTH CENTER OF SOUTH FLORIDA, LLC
Entity type:Organization
Organization Name:MENTAL HEALTH CENTER OF SOUTH FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-510-7381
Mailing Address - Street 1:3761 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5690
Mailing Address - Country:US
Mailing Address - Phone:305-510-7381
Mailing Address - Fax:305-351-8882
Practice Address - Street 1:3761 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5690
Practice Address - Country:US
Practice Address - Phone:305-510-7381
Practice Address - Fax:305-351-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH15781251S00000X
FLIMH13783251S00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty