Provider Demographics
NPI:1225748031
Name:SAPPHIRE MENTAL HEALTH CENTER LLC
Entity Type:Organization
Organization Name:SAPPHIRE MENTAL HEALTH CENTER LLC
Other - Org Name:SAPPHIRE HEALTHCARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:DEL PINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-816-5001
Mailing Address - Street 1:10250 SW 56TH ST STE C202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7098
Mailing Address - Country:US
Mailing Address - Phone:754-816-5001
Mailing Address - Fax:754-816-5208
Practice Address - Street 1:10250 SW 56TH ST STE C202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7098
Practice Address - Country:US
Practice Address - Phone:754-816-5001
Practice Address - Fax:754-816-5208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty