Provider Demographics
NPI:1275330367
Name:LENNOX HEALTH CENTER LLC
Entity type:Organization
Organization Name:LENNOX HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CARVAJAL BERMEJO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC, APRN
Authorized Official - Phone:305-333-9166
Mailing Address - Street 1:142 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1853
Mailing Address - Country:US
Mailing Address - Phone:305-333-9166
Mailing Address - Fax:
Practice Address - Street 1:142 E 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1853
Practice Address - Country:US
Practice Address - Phone:305-333-9166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-26
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty