Living Well Medical Group

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LIVING WELL MEDICAL GROUP

Practice address

344 W 65TH St Ste 201
Hialeah, FL 33012-6719

Phone

(786) 216-5570

NPI assigned

Nov 6, 2018

Organization subpart

No

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

Authorized official

Name

Mairim Gonzalez

Title

President

Phone

(786) 216-5570

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1477021574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 W 65TH ST STE 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126719",
            "telephone_number": "786-216-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 W 65TH ST STE 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126719",
            "telephone_number": "786-216-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MAIRIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-216-5570"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.