Provider Demographics
NPI:1366015307
Name:FLORIDA PERSONAL MANAGEMENT LLC
Entity Type:Organization
Organization Name:FLORIDA PERSONAL MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:MENDOZA ECHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-504-3119
Mailing Address - Street 1:22129 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-2840
Mailing Address - Country:US
Mailing Address - Phone:786-504-3119
Mailing Address - Fax:
Practice Address - Street 1:22129 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-2840
Practice Address - Country:US
Practice Address - Phone:786-504-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)