Provider Demographics
| NPI: | 1295577724 |
|---|---|
| Name: | MIGHTY HEALTH MEDICAL SERVICES, P.A. |
| Entity type: | Organization |
| Organization Name: | MIGHTY HEALTH MEDICAL SERVICES, P.A. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF ADMINISTRATIVE OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | LI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 714-873-6202 |
| Mailing Address - Street 1: | 390 NE 191ST ST STE 8174 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MIAMI |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33179-3899 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 390 NE 191ST ST STE 8174 |
| Practice Address - Street 2: | |
| Practice Address - City: | MIAMI |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33179-3899 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 714-873-6202 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-06-06 |
| Last Update Date: | 2024-06-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 163WG0000X | Nursing Service Providers | Registered Nurse | General Practice | Group - Multi-Specialty |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 171400000X | Other Service Providers | Health & Wellness Coach | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |