Healthcare Provider Details

I. General information

NPI: 1013712827
Provider Name (Legal Business Name): SENIOR SOLUTIONS MIND & BODY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1344 S APOLLO BLVD STE 2C
MELBOURNE FL
32901-3183
US

IV. Provider business mailing address

1344 S APOLLO BLVD STE 2C
MELBOURNE FL
32901-3183
US

V. Phone/Fax

Practice location:
  • Phone: 321-249-2677
  • Fax:
Mailing address:
  • Phone: 321-429-2677
  • Fax: 321-256-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TAMI LEEBERG
Title or Position: NP/OWNER
Credential: AGPCNP-BC
Phone: 321-429-2677