Provider Demographics
NPI:1780306696
Name:MIND PROFESSIONAL MANAGEMENT INC
Entity type:Organization
Organization Name:MIND PROFESSIONAL MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:VILCHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-445-9554
Mailing Address - Street 1:1024 SW 142ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3075
Mailing Address - Country:US
Mailing Address - Phone:305-498-9776
Mailing Address - Fax:786-235-1074
Practice Address - Street 1:2103 CORAL WAY STE 405
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2630
Practice Address - Country:US
Practice Address - Phone:305-445-9554
Practice Address - Fax:786-235-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty