Provider Demographics
NPI: | 1992527485 |
---|---|
Name: | A SOUND MYND WELLNESS LLC. |
Entity type: | Organization |
Organization Name: | A SOUND MYND WELLNESS LLC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PROVIDER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | JOSETTE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HYLTON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PMHNP |
Authorized Official - Phone: | 305-724-6542 |
Mailing Address - Street 1: | 18515 NW 39TH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | MIAMI GARDENS |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33055-2819 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-724-6542 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6151 MIRAMAR PKWY STE 203 |
Practice Address - Street 2: | |
Practice Address - City: | MIRAMAR |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33023-3972 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-724-6542 |
Practice Address - Fax: | 305-630-8583 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-10-28 |
Last Update Date: | 2024-10-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Single Specialty |