Healthcare Provider Details

I. General information

NPI: 1386402444
Provider Name (Legal Business Name): LOVING MINDS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 SW 288TH ST STE 306
HOMESTEAD FL
33033-1223
US

IV. Provider business mailing address

15600 SW 288TH ST STE 306
HOMESTEAD FL
33033-1223
US

V. Phone/Fax

Practice location:
  • Phone: 786-650-2299
  • Fax:
Mailing address:
  • Phone: 786-650-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SUANLY M ASCUNCE GOMEZ
Title or Position: AMBR
Credential:
Phone: 786-236-8627