MEDICARE: BALANCED MIND WELLNESS CENTER, INC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1578382677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALANCED MIND WELLNESS CENTER, INC

Provider Business Mailing Address
First Line	:	8365 NW 170TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-3712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8365 NW 170TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-3712
Country	:	US
Telephone Number	:	786-202-3755
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	MONIQUE MARIE HERNANDEZ
Credential	:	LMHC
Telephone Number	:	786-202-3755

Provider Enumeration Date	:	10/07/2024
Last Update Date	:	01/21/2026

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