Organization Active NPI

Mgo Professional Health Co

  • Psychiatry Physician
  • Miami Lakes, FL
National Provider Identifier
1801102835
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME87958 Issued in FL
Legal business name
MGO PROFESSIONAL HEALTH CO
Practice address
8049 NW 155TH St
Miami Lakes, FL 33016-5874
Phone
(305) 822-2330
Fax
(305) 822-2339
NPI assigned
Aug 27, 2010
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Maribel AguileraNPI 1659343283
Title
MD
Phone
(305) 822-2330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X ME87958 FL Primary

Addresses

Primary practice location

8049 NW 155TH St
Miami Lakes, FL 33016-5874

Mailing address

8049 NW 155TH St
Miami Lakes, FL 33016-5874
Phone (305) 822-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101228000606 FL Part B Supplier - Clinic/Group Practice 1456549948 Receives reassigned benefits from 1 practitioner
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory

Locations

6625 Miami Lakes Dr
Ste 313
Miami Lakes, FL 33014

8049 NW 155th St
Miami Lakes, FL 33016
Phone (305) 822-2330

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1801102835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8049 NW 155TH ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165874",
            "telephone_number": "305-822-2330",
            "fax_number": "305-822-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8049 NW 155TH ST",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165874",
            "telephone_number": "305-822-2330",
            "fax_number": "305-822-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGO PROFESSIONAL HEALTH CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "AGUILERA",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "305-822-2330"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME87958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.

Verify at the official NPI Registry.