Basic Information
| Provider Information | |||||||||
| NPI: | 1164886347 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALTIMIRAS | ||||||||
| FirstName: | BERNAT | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMHC, M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8353 LAKE DR APT 402 | ||||||||
| Address2: | |||||||||
| City: | DORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331667868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7864364244 | ||||||||
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| Practice Location | |||||||||
| Address1: | 419 W 49TH ST STE 210 | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330123657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8558326727 | ||||||||
| FaxNumber: | 7726759100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2016 | ||||||||
| LastUpdateDate: | 02/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.