Provider Demographics
NPI:1346095247
Name:GENTLE MINDS FAMILY CLINIC CORP
Entity Type:Organization
Organization Name:GENTLE MINDS FAMILY CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN/ PMHNP/ FNP/DNP
Authorized Official - Phone:561-897-4189
Mailing Address - Street 1:PO BOX 960244
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33296-0244
Mailing Address - Country:US
Mailing Address - Phone:786-760-5826
Mailing Address - Fax:
Practice Address - Street 1:2110 SW 12TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2203
Practice Address - Country:US
Practice Address - Phone:786-760-5826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty