Basic Information
| Provider Information | |||||||||
| NPI: | 1932654167 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CONTE PSYCHIATRIC LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3741 BATTERSEA RD | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331336701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865463112 | ||||||||
| FaxNumber: | 3052551669 | ||||||||
| Practice Location | |||||||||
| Address1: | 383 W 34TH ST | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330124309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058841744 | ||||||||
| FaxNumber: | 3058841635 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2016 | ||||||||
| LastUpdateDate: | 08/17/2016 | ||||||||
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| AuthorizedOfficialLastName: | CONTE | ||||||||
| AuthorizedOfficialFirstName: | RAFAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7865463112 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | ME58084 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.