Provider Demographics
NPI:1952399750
Name:AZARET, JANELLIE R (MD LMHC)
Entity Type:Individual
Prefix:
First Name:JANELLIE
Middle Name:R
Last Name:AZARET
Suffix:
Gender:F
Credentials:MD LMHC
Other - Prefix:
Other - First Name:JANELLIE
Other - Middle Name:
Other - Last Name:RAMOS MESTEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11880 BIRD RD
Mailing Address - Street 2:STE 319
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3584
Mailing Address - Country:US
Mailing Address - Phone:305-551-6260
Mailing Address - Fax:305-220-1258
Practice Address - Street 1:11880 BIRD RD
Practice Address - Street 2:STE 319
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3584
Practice Address - Country:US
Practice Address - Phone:305-551-6260
Practice Address - Fax:305-220-1258
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8459101YM0800X
FLME47647208000000X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No208000000XAllopathic & Osteopathic PhysiciansPediatrics