MEDICARE: DOCTOR'S MENTAL HEALTH AND BEAUTY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1326845652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR'S MENTAL HEALTH AND BEAUTY LLC

Provider Business Mailing Address
First Line	:	9371 FOUNTAINBLEAU BLVD APT I121
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-5672
Country	:	US
Telephone Number	:	786-278-1181
Fax Number	:	767-606-4886

Provider Business Practice Location Address
First Line	:	2200 SW 16TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2067
Country	:	US
Telephone Number	:	305-456-2502
Fax Number	:	305-631-2967

Authorized Official
Title or Position	:	OWNER
Name	:	ROSY LUZ MARTINEZ
Credential	:
Telephone Number	:	786-278-1181

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	12/12/2025

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