My Roots of Life

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MY ROOTS OF LIFE

Practice address

12863 SW 42ND St
Miami, FL 33175-3434

Phone

(786) 234-1609

NPI assigned

May 29, 2024

Last updated

May 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Vilma Garrido Riquenes, LMHC

Title

License Mental Health Counselor

Phone

(786) 234-1609

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vilma Garrido Riquenes

  • Behavior Technician
  • Long Beach, CA
  • NPI 1205398310
  NPD

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1053151902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17025 NW 52ND PL",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330554018",
            "telephone_number": "786-234-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12863 SW 42ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753434",
            "telephone_number": "786-234-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY ROOTS OF LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "GARRIDO RIQUENES",
        "authorized_official_first_name": "VILMA",
        "authorized_official_title_or_position": "LICENSE MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "786-234-1609",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.