Provider Demographics
NPI:1336010404
Name:FLORIDA COMMUNITY MENTAL HEALTH & MEDICAL CENTER LLC
Entity type:Organization
Organization Name:FLORIDA COMMUNITY MENTAL HEALTH & MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:LOPEZ MEDRANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-608-1091
Mailing Address - Street 1:PO BOX 16434
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-6434
Mailing Address - Country:US
Mailing Address - Phone:954-608-1091
Mailing Address - Fax:800-451-0866
Practice Address - Street 1:7174 NW 50TH ST STE 114
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-5636
Practice Address - Country:US
Practice Address - Phone:954-608-1091
Practice Address - Fax:800-451-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty