Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

125th Street Nm Corp

Organization Specialist · NPI 1619352283

125th Street Nm Corp is a Specialist in North Miami, Florida. Licensed in Florida. Registered with an NPI since 2015.

Licensed in
FL
In the registry since
2015
Specialties on file
3
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

505 NE 125th St
North Miami, FL 33161-4718
Phone: (954) 271-0485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Psychiatry Physician (primary) Taxonomy 2084P0802X
Specialist Taxonomy 174400000X
Physical Therapy Clinic/Center Taxonomy 261QP2000X · Licence PMC20 (FL)

Record details

NPI number1619352283
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Renee Douthat — Cdo · (954) 271-0485
NPI enumeratedJuly 24, 2015
Last updated in NPPESApril 7, 2016
Mailing address505 Ne 125th St, North Miami, FL 33161-4718

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