Provider Demographics
NPI:1184488447
Name:MEDICAL & MENTAL SERVICES INC
Entity type:Organization
Organization Name:MEDICAL & MENTAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HODELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AQUINO GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-683-1865
Mailing Address - Street 1:777 E 25TH ST STE 507
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3834
Mailing Address - Country:US
Mailing Address - Phone:786-683-1865
Mailing Address - Fax:
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:SUITE 212
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3834
Practice Address - Country:US
Practice Address - Phone:786-683-1865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty