KETAMINE HEALTH CENTERS LLC NPI 1811488554

NPI Information

NPI: 1811488554
Provider Name: KETAMINE HEALTH CENTERS, LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
9408 SW 87TH AVE STE 302
MIAMI, FL
ZIP 33176
Phone: (305) 856-9442
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KETAMINE HEALTH CENTERS, LLC is a health service clinic center in Miami, FL. KETAMINE HEALTH CENTERS, LLC NPI is 1811488554. The provider is registered as an organization entity type.

The provider's business location address is:

9408 SW 87TH AVE STE 302
MIAMI, FL
ZIP 33176-416
Phone: (305) 856-9442

The provider's authorized official is Raul A Cruz .
The authorized official title is Medical Director and has the following contact phone number (305) 856-9442.

The enumeration date for this NPI number is 5/29/2018 and was last updated on 1/20/2022.

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	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	607228	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1144421454	MEDICAID	FLORIDA
2	1104163294	MEDICAID	FLORIDA
3	1194817221	MEDICAID	FLORIDA
4	187533935	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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