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Organization

SUPRA MEDICAL GROUP II, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KLEYDSON NEVES DA SILVA OWNER (MANAGER)
(786) 205-4515
Entity
Organization

Contact information

Practice address
10300 SW 72ND ST STE 387, MIAMI, FL 33173-3020
(305) 200-5210
(305) 200-5780
Mailing address
10300 SUNSET DR STE 101, MIAMI, FL 33173-3038

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TP2701X
Group Psychotherapy Psychologist
208D00000X
General Practice Physician
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
03/20/2017
Last updated
05/29/2025
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