Active NPI
Tal Community Mental Health Center LLC
- Community/Behavioral Health Agency
- Miramar, FL
National Provider Identifier
1235715236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- TAL COMMUNITY MENTAL HEALTH CENTER LLC
- Practice address
- 12781 Miramar Parkway
Suite 203
Miramar, FL 33027 - Phone
- (786) 648-3588
- Fax
- (786) 698-7677
- NPI assigned
- Mar 20, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gaston I Bogomolni
- Title
- Owner-Cfo
- Phone
- (786) 648-3588
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
12781 Miramar Parkway
Suite 203
Miramar, FL 33027
Mailing address
12781 Miramar Parkway
Suite 203
Miramar, FL 33027
Phone (786) 648-3588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109921400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
12781 Miramar Pkwy
Ste 203
Miramar, FL 33027
Phone (786) 648-3588
1400 NE Miami Gardens Dr
Ste 216
North Miami Beach, FL 33179
Phone (786) 830-5880
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Marriage & Family Therapist
- Miami Gardens, FL
- NPI 1043231681
-
- Clinical Social Worker
- Hollywood, FL
- NPI 1740685767
-
- Clinical Social Worker
- Miramar, FL
- NPI 1528722683
-
- Mental Health Counselor
- Weston, FL
- NPI 1366263154
-
- Clinical Psychologist
- Lake Worth, FL
- NPI 1679451421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616198400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1670803200000",
"number": "1235715236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12781 MIRAMAR PARKWAY",
"address_2": "SUITE 203",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "33027",
"telephone_number": "786-648-3588",
"fax_number": "786-698-7677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12781 MIRAMAR PARKWAY",
"address_2": "SUITE 203",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "33027",
"telephone_number": "786-648-3588",
"fax_number": "786-698-7677"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TAL COMMUNITY MENTAL HEALTH CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-20",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A",
"authorized_official_last_name": "BOGOMOLNI",
"authorized_official_first_name": "GASTON",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "OWNER-CFO",
"authorized_official_telephone_number": "786-648-3588"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109921400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.