Provider Demographics
NPI:1639968159
Name:OPTIMAL MIND & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:OPTIMAL MIND & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMNHP
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN11002289
Authorized Official - Phone:954-765-6505
Mailing Address - Street 1:3408 W 84TH ST STE 309
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4944
Mailing Address - Country:US
Mailing Address - Phone:954-290-3869
Mailing Address - Fax:
Practice Address - Street 1:3408 W 84TH ST STE 309
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4944
Practice Address - Country:US
Practice Address - Phone:954-290-3869
Practice Address - Fax:954-861-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)