Individual provider Active NPI

Maxiel Amareyis Mateo, LMFT, RN

  • Marriage & Family Therapist
  • Pembroke Pines, FL
National Provider Identifier
1902223670
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4630 Issued in FL
Practice address
1117 SW 123Rd Ave
Pembroke Pines, FL 33025-5770
Phone
(786) 663-3265
NPI assigned
Mar 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9648954 FL
Marriage & Family Therapist 106H00000X MT4630 FL Primary

Addresses

Primary practice location

1117 SW 123Rd Ave
Pembroke Pines, FL 33025-5770

Mailing address

1117 SW 123Rd Ave
Pembroke Pines, FL 33025-5770
Phone (786) 663-3265

Other names 1

  • Maxiel Amareyis Mateo-Foxx Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
MT4630FLMDMarriage & Family Therapist
9648954FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Mar 5, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients
A New Beginning Behavioral Services, Inc Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1902223670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 SW 123RD AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255770",
            "telephone_number": "786-663-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SW 123RD AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255770",
            "telephone_number": "786-663-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO",
        "first_name": "MAXIEL",
        "middle_name": "AMAREYIS",
        "credential": "LMFT, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9648954",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXIEL",
            "last_name": "MATEO-FOXX",
            "middle_name": "AMAREYIS",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.