Provider Demographics
NPI:1184513046
Name:TWELVE OAKS PSYCHIATRY
Entity type:Organization
Organization Name:TWELVE OAKS PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:954-295-5825
Mailing Address - Street 1:9441 SW 50TH ST
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-4142
Mailing Address - Country:US
Mailing Address - Phone:954-295-5825
Mailing Address - Fax:754-315-2744
Practice Address - Street 1:10400 GRIFFIN RD STE 201
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3321
Practice Address - Country:US
Practice Address - Phone:954-295-5825
Practice Address - Fax:754-315-2744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health