Jesus Tormo Jr.
Individual provider Active NPI Mental Health Counselor · Miami, FL
NPI 1104207307 · NPPES record last updated Nov 2, 2023
Key facts
- NPI
- 1104207307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 22790 SW 112TH Ave
Miami, FL 33170-7602 - Phone
- (305) 235-2616
- Fax
- (305) 235-6178
- NPI assigned
- Jun 12, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240126001320 | FL | Practitioner - Mental Health Counselor | 7012360977 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agape Network, Inc. | Current |
Accepting new patients | |
| Agape Network, Inc. | Current |
Accepting new patients |
Locations
22790 SW 112th Ave
Fl Jail
Miami, FL 33170
Phone (305) 235-2616
22790 SW 112th Ave
Miami, FL 33170
Phone (305) 235-2616
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
22790 SW 112TH Ave
Miami, FL 33170-7602
Mailing address
6100 Blue Lagoon Dr
Suite 400
Miami, FL 33126-2079
Phone (305) 398-6100
Other practice location 1
10 NW 42nd Ave
Suite 500
Miami, FL 33126-5473
Phone (305) 398-6100
Other providers in Miami, FL
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- Leydy Toribio Fabelo
- Amneris Toribio Martinez
- Monika Lehmann Toribio
- Jaime F. Tormo
- Maria del Pilar Tormo
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- Ismelys Torna Valido
- Jessica Michelle Torna
All providers in Miami, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.