Healthcare Provider Details

I. General information

NPI: 1265616049
Provider Name (Legal Business Name): HEALTH OF MIND, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PONCE DE LEON BLVD STE 1201
CORAL GABLES FL
33134-4476
US

IV. Provider business mailing address

2020 PONCE DE LEON BLVD STE 1201
CORAL GABLES FL
33134-4476
US

V. Phone/Fax

Practice location:
  • Phone: 305-917-5414
  • Fax: 305-220-1864
Mailing address:
  • Phone: 305-917-5414
  • Fax: 305-220-1864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPY8713
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA11830222
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY8713
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberPY8713
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPY8713
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License NumberPY8713
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberPY8713
License Number StateFL

VIII. Authorized Official

Name: DR. FRANK R. PEREZ-VERDECIA
Title or Position: PRESIDENT
Credential: PSY.D., LMHC, BCBA
Phone: 305-917-5414