Healthcare Provider Details

I. General information

NPI: 1467288803
Provider Name (Legal Business Name): PEACEFUL PROGRESS MIAMI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3785 NW 82ND AVE STE 307
DORAL FL
33166-6631
US

IV. Provider business mailing address

3785 NW 82ND AVE STE 307
DORAL FL
33166-6631
US

V. Phone/Fax

Practice location:
  • Phone: 305-898-5420
  • Fax:
Mailing address:
  • Phone: 786-558-4732
  • Fax: 786-359-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MAYELIN GONZALEZ POMBART
Title or Position: CEO
Credential:
Phone: 786-558-4732