Provider Demographics
NPI:1083116420
Name:SOUTH MIAMI RECOVERY, INC
Entity Type:Organization
Organization Name:SOUTH MIAMI RECOVERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:CAP
Authorized Official - Phone:305-733-9655
Mailing Address - Street 1:7520 S RED RD STE E1
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5330
Mailing Address - Country:US
Mailing Address - Phone:305-661-0055
Mailing Address - Fax:
Practice Address - Street 1:7520 SW 57TH AVE STE K
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5330
Practice Address - Country:US
Practice Address - Phone:305-661-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1301324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility