Organization Active NPI

Mind Professional Management Inc

  • Clinical Psychologist
  • Miami, FL
National Provider Identifier
1780306696
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MIND PROFESSIONAL MANAGEMENT INC
Practice address
2103 Coral Way Ste 405
Miami, FL 33145-2630
Phone
(305) 445-9554
Fax
(786) 235-1074
NPI assigned
Sep 16, 2022
Last updated
Sep 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Adriana D Vilches
Title
President
Phone
(305) 445-9554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

2103 Coral Way Ste 405
Miami, FL 33145-2630

Mailing address

1024 SW 142ND PL
Miami, FL 33184-3075
Phone (305) 498-9776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250910003366 FL Part B Supplier - Clinic/Group Practice 5395248983 Receives reassigned benefits from 5 practitioners
Practice locations: Coral Gables, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1780306696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 SW 142ND PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331843075",
            "telephone_number": "305-498-9776",
            "fax_number": "786-235-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 CORAL WAY STE 405",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452630",
            "telephone_number": "305-445-9554",
            "fax_number": "786-235-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND PROFESSIONAL MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "VILCHES",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-445-9554"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "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 Sep 16, 2022; 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.