NPIMap

Organization Active NPI

Mentally Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1053064675
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MENTALLY PSYCHIATRY LLC
Practice address
10689 N Kendall Dr Ste 211
Miami, FL 33176-1594
Phone
(305) 204-9499
Fax
(507) 607-8720
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Dr. Jose Gabriel Valdes, DNP, APRN, PMHNP-BCNPI 1235771288
Title
Ceo
Phone
(786) 208-0065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

10689 N Kendall Dr Ste 211
Miami, FL 33176-1594

Mailing address

10689 N Kendall Dr Ste 211
Miami, FL 33176-1594
Phone (305) 204-9499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260624000069 FL Part B Supplier - Clinic/Group Practice 9537632344 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

10689 N Kendall Dr
Ste 211
Miami, FL 33176
Phone (305) 204-9499

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1053064675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10689 N KENDALL DR STE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761594",
            "telephone_number": "305-204-9499",
            "fax_number": "507-607-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10689 N KENDALL DR STE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761594",
            "telephone_number": "305-204-9499",
            "fax_number": "507-607-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTALLY PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-208-0065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.