Organization Active NPI

Heavenly Soul'S Care

  • Psychiatric/Mental Health Nurse Practitioner
  • North Miami, FL
National Provider Identifier
1689248064
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HEAVENLY SOUL'S CARE
Practice address
13000 NE 12TH Ave
North Miami, FL 33161-4305
Phone
(786) 999-9909
NPI assigned
May 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Rosie Michel, PMHNP-BCNPI 1699372003
Title
Manager
Phone
(786) 999-9909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

13000 NE 12TH Ave
North Miami, FL 33161-4305

Mailing address

16756 NE 4TH CT
North Miami Beach, FL 33162-3975
Phone (786) 999-9909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210914000416 FL Part B Supplier - Clinic/Group Practice 2961808118 Receives reassigned benefits from 4 practitioners
Practice locations: North Miami, FL; Miami Gardens, FL

National Provider Directory

National Provider Directory

Locations

111 NW 183rd St
Ste 203
Miami Gardens, FL 33169
Phone (305) 878-9718

16756 NE 4th Ct
North Miami Beach, FL 33162

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1689248064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16756 NE 4TH CT",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623975",
            "telephone_number": "786-999-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 NE 12TH AVE",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614305",
            "telephone_number": "786-999-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY SOUL'S CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "MICHEL",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-999-9909",
        "authorized_official_credential": "PMHNP-BC"
    },
    "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 North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.