Provider Demographics
NPI:1174177554
Name:MIAMI BEACH MOOD AND ADHD THERAPIES LLC
Entity type:Organization
Organization Name:MIAMI BEACH MOOD AND ADHD THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-398-2477
Mailing Address - Street 1:2813 EXECUTIVE PARK DR STE 126
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3603
Mailing Address - Country:US
Mailing Address - Phone:954-247-1557
Mailing Address - Fax:786-633-3688
Practice Address - Street 1:2813 EXECUTIVE PARK DR STE 126
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3603
Practice Address - Country:US
Practice Address - Phone:954-247-1557
Practice Address - Fax:786-633-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty