Lighthouse Medical Group of Florida Inc

Primary specialty

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

Legal business name

LIGHTHOUSE MEDICAL GROUP OF FLORIDA INC

Practice address

85 Grand Canal Dr Ste 102
Miami, FL 33144-2566

Phone

(786) 703-6967

Fax

(786) 703-6972

NPI assigned

Jan 15, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Javier Ortiz

Title

President

Phone

(305) 606-3543

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1770057671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GRAND CANAL DR STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442566",
            "telephone_number": "786-703-6967",
            "fax_number": "786-703-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 GRAND CANAL DR STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442566",
            "telephone_number": "786-703-6967",
            "fax_number": "786-703-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE MEDICAL GROUP OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-606-3543",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "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": []
}

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• Andrea Liguori, ARNP
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• Kelly Suzanne Liker, MD, MBA
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• Mental Health Clinic/Center (Including Community Mental Health Center) in Miami, FL
• Providers in Miami, 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 8, 2019; 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.