Provider Demographics
NPI:1518657915
Name:HEALTHY MIND USA LLC
Entity Type:Organization
Organization Name:HEALTHY MIND USA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:RONDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:833-969-6463
Mailing Address - Street 1:17422 SW 74TH CT
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6341
Mailing Address - Country:US
Mailing Address - Phone:833-969-6463
Mailing Address - Fax:
Practice Address - Street 1:400 N ASHLEY DR STE 2600
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4310
Practice Address - Country:US
Practice Address - Phone:833-969-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GAUCHO HOLDINGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty