Provider Demographics
NPI:1447062823
Name:AFFINITY PSYCHIATRIC GROUP
Entity type:Organization
Organization Name:AFFINITY PSYCHIATRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PAYARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:645-214-4575
Mailing Address - Street 1:9221 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3102
Mailing Address - Country:US
Mailing Address - Phone:645-214-4575
Mailing Address - Fax:
Practice Address - Street 1:9221 SW 11TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3102
Practice Address - Country:US
Practice Address - Phone:645-214-4575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty