Healthcare Provider Details

I. General information

NPI: 1992648497
Provider Name (Legal Business Name): MIRTHA BLONDET RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIRTHA SUSANA BLONDET MEJIA

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 MADRUGA AVE STE 509
CORAL GABLES FL
33146-3048
US

IV. Provider business mailing address

18266 MEDITERRANEAN BLVD APT 803
HIALEAH FL
33015-5718
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-9714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH23899
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: