Provider Demographics
NPI:1912927310
Name:INNER REFLECTION CMHC, INC.
Entity Type:Organization
Organization Name:INNER REFLECTION CMHC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:IZQUIERDO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-576-4279
Mailing Address - Street 1:2125 BISCAYNE BLVD
Mailing Address - Street 2:550
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5031
Mailing Address - Country:US
Mailing Address - Phone:305-576-4279
Mailing Address - Fax:305-576-4861
Practice Address - Street 1:2125 BISCAYNE BLVD
Practice Address - Street 2:550
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5031
Practice Address - Country:US
Practice Address - Phone:305-576-4279
Practice Address - Fax:305-576-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101477Medicare ID - Type UnspecifiedCMHC