Energy Community Mental Health Clinic LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ENERGY COMMUNITY MENTAL HEALTH CLINIC LLC

Practice address

4995 NW 72ND Ave
Miami, FL 33166-5643

Phone

(786) 360-3584

Fax

(786) 360-3867

NPI assigned

Dec 27, 2021

Organization subpart

No

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

Authorized official

Name

Ernesto Rodriguez Tanquero

Title

Authorized Official

Phone

(786) 520-0140

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Energy Community Mental Health Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Energy Community Mental Health Clinic LLC

  • Family Medicine Physician
  • Miami, FL
  • NPI 1295310514
  NPD tax ID

Locations

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1851051262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "786-360-3584",
            "fax_number": "786-360-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "786-360-3584",
            "fax_number": "786-360-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGY COMMUNITY MENTAL HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ TANQUERO",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-520-0140"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112486800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Energy Community Mental Health Clinic LLC
• Energy With Nathalie
• Ana Iris Eng Echevarria
• Daniel Chow Eng, PA-C
• Laurie Eng, PHARM. D.
• Jonathan Scott England, MD

• Mental Health Counselor in Miami, FL
• Providers in Miami, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.