NPIMap

Individual provider Active NPI

Bliss Quintana, PSY.D.

  • Clinical Neuropsychologist
  • Miami, FL
National Provider Identifier
1144044660
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY12317 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 585-9600
NPI assigned
Nov 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY12317 FL
Clinical Neuropsychologist 103G00000X PY12317 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

322 Costanera Rd
Coral Gables, FL 33143-6563
Phone (786) 325-5920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109001870 FL Practitioner - Clinical Psychologist 3870021421 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 0244380434, 469 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY12317FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Jan 6, 2025 Accepting new patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Dade County Florida CurrentSince Jan 6, 2025 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Jan 6, 2025 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Jan 6, 2025 Accepting new patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Jan 6, 2025 Accepting new patients

Locations

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1695 NW 9th Ave
Miami, FL 33136
Phone (305) 355-7147

20201 NW 37th Ave
Opa Locka, FL 33056
Phone (786) 466-2700

15055 NW 27th Ave
Opa Locka, FL 33054
Phone (786) 466-2701

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1144044660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 COSTANERA RD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331436563",
            "telephone_number": "786-325-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "BLISS",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY12317",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY12317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.