SUPRA MEDICAL GROUP II LLC NPI 1033650221

NPI Information

NPI: 1033650221
Provider Name: SUPRA MEDICAL GROUP II, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

CLIA Number: 10D2262339

Address:
10300 SW 72ND ST STE 101
MIAMI, FL
ZIP 33173
Phone: (305) 200-5210
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SUPRA MEDICAL GROUP II, LLC is a mental health counselor in Miami, FL. SUPRA MEDICAL GROUP II, LLC NPI is 1033650221. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10300 SW 72ND ST STE 101
MIAMI, FL
ZIP 33173-038
Phone: (305) 200-5210
Fax: (305) 200-5780

The provider's authorized official is Kleydson Neves Da Silva .
The authorized official title is Manager and has the following contact phone number (786) 205-4515.

The CLIA number assigned to this NPI record is 10D2262339 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2017 and was last updated on 11/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	103TP2701X	Psychologist	Group Psychotherapy	No
2	208D00000X	General Practice		No
3	251S00000X	Community/Behavioral Health		No
4	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
5	101YM0800X	Counselor	Mental Health	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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