Provider Demographics
NPI:1447462346
Name:BEHAVIORAL MEDICINE SERVICES OF SOUTH FLORIDA
Entity type:Organization
Organization Name:BEHAVIORAL MEDICINE SERVICES OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZARET
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-669-6492
Mailing Address - Street 1:3200 SW 60TH CT
Mailing Address - Street 2:STE 302
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4071
Mailing Address - Country:US
Mailing Address - Phone:305-669-6492
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:STE 3-266
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-669-6503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty