Miyas Place LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MIYAS PLACE LLC

Practice address

2500 Hollywood Blvd Ste 104
Hollywood, FL 33020-6615

Phone

(305) 903-2505

NPI assigned

Sep 27, 2023

Organization subpart

No

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

Authorized official

Name

Daneisha Freeman, LCSW

Title

Manager

Phone

(305) 903-2505

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1184403255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 SW 109TH AVE APT 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255544",
            "telephone_number": "305-903-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOLLYWOOD BLVD STE 104",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206615",
            "telephone_number": "305-903-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIYAS PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "DANEISHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-903-2505",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Mitchell, LCSW
• Jennifer Marguerite Mitchell, L.M
• Mivip Behavioral Health LLC
• Mixlab, Inc.
• Idarmis Miyares Romero, FNP-C
• MJ Doc Health Center 2 Inc
• Mjlifechangingcompanionshipllc
• MKB Psychology PA
• Ayellet Moas
• Mobile Vision Doctors LLC

• Adolescent and Children Mental Health Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.