Organization Active NPI

Healthy Living Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1417770694
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HEALTHY LIVING CARE LLC
Practice address
11890 SW 8TH St Ste 404
Miami, FL 33184-1710
Phone
(786) 285-5803
NPI assigned
Nov 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Desiree Abraham, APRN
Title
Ceo
Phone
(786) 285-5803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

11890 SW 8TH St Ste 404
Miami, FL 33184-1710

Mailing address

15120 SW 33Rd Ter
Miami, FL 33185-4915
Phone (786) 285-5803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241111003362 FL Part B Supplier - Clinic/Group Practice 8426582636 Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

11890 SW 8th St
Ste 404
Miami, FL 33184
Phone (305) 223-3600

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1417770694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15120 SW 33RD TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331854915",
            "telephone_number": "786-285-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11890 SW 8TH ST STE 404",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841710",
            "telephone_number": "786-285-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-285-5803",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-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 Nov 5, 2024; 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.