Sports Konnect Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SPORTS KONNECT INC.

Doing business as

Sports Konnect Youth Move

Practice address

2103 Coral Way FL 2
Coral Gables, FL 33145-2601

Phone

(786) 235-8030

NPI assigned

Mar 5, 2020

Organization subpart

No

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

Authorized official

Name

Devin A Browne

Title

Owner

Phone

(786) 382-3014

Specialties & licenses 2

Addresses

Other names 1

• Sports Konnect Youth Move Doing business as

Locations

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1154956639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 CORAL WAY FL 2",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331452601",
            "telephone_number": "786-235-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 CORAL WAY FL 2",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331452601",
            "telephone_number": "786-235-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS KONNECT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "BROWNE",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-382-3014"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Konnect Youth Move",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sports Konnect Youth Move",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.