Healthcare Provider Details

I. General information

NPI: 1245119528
Provider Name (Legal Business Name): MOOD CHANGES COMMUNITY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 ALHAMBRA CIR STE 210
CORAL GABLES FL
33134-5116
US

IV. Provider business mailing address

299 ALHAMBRA CIR STE 210
CORAL GABLES FL
33134-5116
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-5729
  • Fax: 786-598-7755
Mailing address:
  • Phone: 786-558-5729
  • Fax: 786-598-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YOANKA NARANJO FUNDORA
Title or Position: OWNER
Credential:
Phone: 786-558-5729