Provider Demographics
NPI:1639230469
Name:HEALTHY CONNECTION CMHC INC
Entity Type:Organization
Organization Name:HEALTHY CONNECTION CMHC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-646-0112
Mailing Address - Street 1:2780 SW 37TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2740
Mailing Address - Country:US
Mailing Address - Phone:305-646-0112
Mailing Address - Fax:
Practice Address - Street 1:2780 SW 37TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2740
Practice Address - Country:US
Practice Address - Phone:305-646-0112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL002349500251B00000X
FL076321700251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101437Medicare Oscar/Certification