Individual provider Active NPI

Glenda Diaz Mora, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1649195330
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11049851 Issued in FL
Practice address
5347 NW 188TH St
Miami Gardens, FL 33055-2369
Phone
(786) 333-8635
NPI assigned
Aug 11, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 11049851 FL Primary

Addresses

Primary practice location

5347 NW 188TH St
Miami Gardens, FL 33055-2369

Mailing address

5347 NW 188TH St
Miami Gardens, FL 33055-2369
Phone (786) 333-8635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1649195330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5347 NW 188TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552369",
            "telephone_number": "786-333-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5347 NW 188TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552369",
            "telephone_number": "786-333-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ MORA",
        "first_name": "GLENDA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11049851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.