Provider Demographics
NPI:1710105481
Name:SOUL GATE INC
Entity Type:Organization
Organization Name:SOUL GATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SILVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-672-1589
Mailing Address - Street 1:7135 COLLINS AVE
Mailing Address - Street 2:SUITE 811
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3238
Mailing Address - Country:US
Mailing Address - Phone:305-672-1589
Mailing Address - Fax:305-672-1589
Practice Address - Street 1:7135 COLLINS AVE
Practice Address - Street 2:SUITE 811
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3238
Practice Address - Country:US
Practice Address - Phone:305-672-1589
Practice Address - Fax:305-672-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0005080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9902OtherBLUE CROSS BLUE SHIELD