Healthcare Provider Details

I. General information

NPI: 1245157916
Provider Name (Legal Business Name): MAJESTIC MINDS BEHAVIORAL SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7699 W 36TH AVE APT 3
HIALEAH FL
33018-1697
US

IV. Provider business mailing address

7699 W 36TH AVE APT 3
HIALEAH FL
33018-1697
US

V. Phone/Fax

Practice location:
  • Phone: 786-786-5261
  • Fax: 239-790-2711
Mailing address:
  • Phone: 786-786-5261
  • Fax: 239-790-2711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CARMINA LUISA LEON
Title or Position: CLINICAL DIRECTOR - BCBA
Credential:
Phone: 786-786-5261