Organization
ADVANCED MENTAL HEALTH CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUCIA CARRENO (PRESIDENT/ADMINISTRATOR)
(305) 480-7839
Entity
Organization
Contact information
Practice address
13055 SW 42ND ST STE 104, MIAMI, FL 33175-3470
(305) 480-7839
(305) 480-7892
Mailing address
13055 SW 42ND ST STE 104, MIAMI, FL 33175-3470
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
101490
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EO918A
MEDICARE PART B
FL
Enumeration date
06/12/2006
Last updated
09/01/2020
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