NPIMap

Organization Active NPI

Center for Human Formation, LLC

  • Psychologist
  • Coral Gables, FL
National Provider Identifier
1831428838
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 7327 Issued in FL
Legal business name
CENTER FOR HUMAN FORMATION, LLC
Practice address
301 Almeria Ave
Suite 210
Coral Gables, FL 33134-5822
Phone
(786) 879-7007
NPI assigned
Dec 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Dr. Carlos Camilo Gomez, PHDNPI 1770638637
Title
Psychologist
Phone
(786) 879-7007

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY 7327 FL Primary

Addresses

Primary practice location

301 Almeria Ave
Suite 210
Coral Gables, FL 33134-5822

Mailing address

PO Box 140432
Coral Gables, FL 33114-0432
Phone (786) 879-7007

National Provider Directory

National Provider Directory

Locations

301 Almeria Ave
Ste 210
Coral Gables, FL 33134
Phone (786) 879-7007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1831428838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140432",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331140432",
            "telephone_number": "786-879-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ALMERIA AVE",
            "address_2": "SUITE 210",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345822",
            "telephone_number": "786-879-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR HUMAN FORMATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "CAMILO",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "786-879-7007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.