Provider Demographics
NPI:1508441924
Name:J B MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:J B MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:BURGOS MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-230-4519
Mailing Address - Street 1:4649 PONCE DE LEON BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2118
Mailing Address - Country:US
Mailing Address - Phone:786-230-4519
Mailing Address - Fax:
Practice Address - Street 1:4649 PONCE DE LEON BLVD STE 302
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2118
Practice Address - Country:US
Practice Address - Phone:786-230-4519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health