Organization Active NPI

Mental Wellness of Florida PA

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1699495218
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MENTAL WELLNESS OF FLORIDA PA
Practice address
3661 S Miami Ave Ste 503
Miami, FL 33133-4200
Phone
(305) 856-1082
Fax
(305) 459-1926
NPI assigned
Sep 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Mrs. Lisandra Hernandez
Title
Owner/Aprn
Phone
(786) 223-2181

Specialties & licenses 1

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

Addresses

Primary practice location

3661 S Miami Ave Ste 503
Miami, FL 33133-4200

Mailing address

18000 SW 113TH Ave
Miami, FL 33157-4922
Phone (888) 684-2779

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230118002524 FL Part B Supplier - Clinic/Group Practice 2466823083 Receives reassigned benefits from 4 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1699495218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 SW 113TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331574922",
            "telephone_number": "888-684-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE STE 503",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334200",
            "telephone_number": "305-856-1082",
            "fax_number": "305-459-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS OF FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "LISANDRA",
        "authorized_official_title_or_position": "OWNER/APRN",
        "authorized_official_telephone_number": "786-223-2181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE 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 Jan 24, 2023; 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.