Provider Demographics
NPI:1497190789
Name:MIAMI CENTER FOR COGNITIVE THERAPY, LLC
Entity Type:Organization
Organization Name:MIAMI CENTER FOR COGNITIVE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ISRAEL
Authorized Official - Last Name:PEREZ BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:867-467-7006
Mailing Address - Street 1:6101 SW 63RD CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-2157
Mailing Address - Country:US
Mailing Address - Phone:786-467-7006
Mailing Address - Fax:
Practice Address - Street 1:1701 W FLAGLER ST STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2099
Practice Address - Country:US
Practice Address - Phone:786-467-7006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8052103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty