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Complete NPI Record 1467242628
Clinic/Center - Mental Health (Including Community Mental Health Center) in Cutler Bay, FL

NPI Status: Active since May 10, 2025

Contact Information

10166 SW 223RD TER
CUTLER BAY, FL
ZIP 33190
Phone: (305) 481-3008

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Business Practice Location Address City Name
  12. Provider Business Practice Location Address State Name
  13. Provider Business Practice Location Address Postal Code
  14. Provider Business Practice Location Address Country Code If outside U S
  15. Provider Business Practice Location Address Telephone Number
  16. Provider Enumeration Date
  17. Last Update Date
  18. Authorized Official Last Name
  19. Authorized Official First Name
  20. Authorized Official Middle Name
  21. Authorized Official Title or Position
  22. Authorized Official Telephone Number
  23. Healthcare Provider Taxonomy Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Is Organization Subpart
  26. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1467242628. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1467242628
The city name in the mailing address of the provider being identified.
Entity Type Code: 2
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 10166 SW 223RD TER
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: CUTLER BAY
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: FL
The city name in the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 331901569
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 10166 SW 223RD TER
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CUTLER BAY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: FL
The date that a record was last updated or changed.
Provider Business Practice Location Address Postal Code: 331901569
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3054813008
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/10/2025
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 5/10/2025
The date that a record was last updated or changed.
Authorized Official Last Name: GARCIA DE LA TORRE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: CARLOS
The first name of the authorized official.
Authorized Official Middle Name: ALEJANDRO
The middle name of the authorized official.
Authorized Official Title or Position: CO-OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 3054813008
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QM0801X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
NPI Certification Date: 5/10/2025