Provider Demographics
NPI:1467915777
Name:MENTAL HEALTH INSTITUTE OF FLORIDA LLC
Entity type:Organization
Organization Name:MENTAL HEALTH INSTITUTE OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:FELICIANO
Authorized Official - Last Name:MAMBUCA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD,MS,LMHC
Authorized Official - Phone:954-663-8086
Mailing Address - Street 1:3311 SW 195TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5881
Mailing Address - Country:US
Mailing Address - Phone:954-663-8086
Mailing Address - Fax:954-251-7005
Practice Address - Street 1:1921 NW 150TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2872
Practice Address - Country:US
Practice Address - Phone:786-393-0361
Practice Address - Fax:954-251-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty