Provider Demographics
NPI:1336902386
Name:PSYCHE HARMONY GROUP, LLC.
Entity type:Organization
Organization Name:PSYCHE HARMONY GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-987-1007
Mailing Address - Street 1:2100 PONCE DE LEON BLVD STE 1240
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5215
Mailing Address - Country:US
Mailing Address - Phone:305-987-1007
Mailing Address - Fax:
Practice Address - Street 1:2100 PONCE DE LEON BLVD STE 1240
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5215
Practice Address - Country:US
Practice Address - Phone:305-987-1007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center