Provider Demographics
NPI:1588312235
Name:A MINDFUL SOLUTION LLC
Entity type:Organization
Organization Name:A MINDFUL SOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURES PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARKETA
Authorized Official - Middle Name:DANYALLE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-614-3599
Mailing Address - Street 1:13817 CARLOW PARK DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-2149
Mailing Address - Country:US
Mailing Address - Phone:904-887-4351
Mailing Address - Fax:
Practice Address - Street 1:13817 CARLOW PARK DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-2149
Practice Address - Country:US
Practice Address - Phone:904-887-4351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty