Healthcare Provider Details

I. General information

NPI: 1033739156
Provider Name (Legal Business Name): SALUDABLEMENTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8180 NW 36TH ST STE 100
DORAL FL
33166-6650
US

IV. Provider business mailing address

9940 COSTA DEL SOL BLVD
DORAL FL
33178-2357
US

V. Phone/Fax

Practice location:
  • Phone: 786-486-2798
  • Fax:
Mailing address:
  • Phone: 786-486-2798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANA MATEO
Title or Position: PRESIDENT
Credential:
Phone: 786-486-2798