Healthcare Provider Details

I. General information

NPI: 1528929650
Provider Name (Legal Business Name): IT'S VIVACE EXPRESSIVE THERAPY & MORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 W 78TH TER
HIALEAH FL
33014-3350
US

IV. Provider business mailing address

1570 W 78TH TER
HIALEAH FL
33014-3350
US

V. Phone/Fax

Practice location:
  • Phone: 786-674-0697
  • Fax: 786-936-1191
Mailing address:
  • Phone: 786-674-0697
  • Fax: 786-936-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DIANEL DIEGUEZ NUNEZ SR.
Title or Position: GENERAL MANAGER
Credential: ET
Phone: 786-526-8839