Healthcare Provider Details

I. General information

NPI: 1669390555
Provider Name (Legal Business Name): KATHY & CO. PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 W 17TH ST
HIALEAH FL
33010-2413
US

IV. Provider business mailing address

532 W 17TH ST
HIALEAH FL
33010-2413
US

V. Phone/Fax

Practice location:
  • Phone: 305-815-5107
  • Fax:
Mailing address:
  • Phone: 786-505-9444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. NAYBI ELISA ROSELLON
Title or Position: OWNER
Credential: DNP, PMHNP-BC
Phone: 305-815-5107