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Individual

MARCOS JOSE CARVAJAL BERMEJO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP, PMHNP-BC, APRN

Contact information

Practice address
16430 NW 59TH AVE STE 202, MIAMI LAKES, FL 33014-5605
(754) 201-5811
Mailing address
16430 NW 59TH AVE STE 202, MIAMI LAKES, FL 33014-5605
(786) 638-1508

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APRN11017076
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11017076
FL

Other

Enumeration date
12/20/2021
Last updated
12/12/2024
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