Provider Demographics
NPI:1083334718
Name:PASITHEA CLINICS
Entity Type:Organization
Organization Name:PASITHEA CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIAGO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-917-3919
Mailing Address - Street 1:1111 LINCOLN RD STE 500
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2439
Mailing Address - Country:US
Mailing Address - Phone:618-917-3919
Mailing Address - Fax:
Practice Address - Street 1:1800 SW 1ST AVE STE 603
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1181
Practice Address - Country:US
Practice Address - Phone:305-807-3133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center