Healthcare Provider Details
I. General information
NPI: 1245103670
Provider Name (Legal Business Name): MIND & BODY IN MOTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6230 WILES RD APT 207
CORAL SPRINGS FL
33067-4333
US
IV. Provider business mailing address
6230 WILES RD APT 207
CORAL SPRINGS FL
33067-4333
US
V. Phone/Fax
- Phone: 754-757-5422
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
MILENE
MAJDALANI
Title or Position: MBR
Credential:
Phone: 754-757-5422