Provider Demographics
NPI:1043765605
Name:MIAMI PSYCHIATRIC SERVICES, LLC.
Entity Type:Organization
Organization Name:MIAMI PSYCHIATRIC SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-355-9682
Mailing Address - Street 1:12260 SW 8TH ST
Mailing Address - Street 2:SUITE 154
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1551
Mailing Address - Country:US
Mailing Address - Phone:786-409-5503
Mailing Address - Fax:
Practice Address - Street 1:12260 SW 8TH ST
Practice Address - Street 2:SUITE 154
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1551
Practice Address - Country:US
Practice Address - Phone:786-409-5503
Practice Address - Fax:786-452-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122666261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)