Healthcare Provider Details

I. General information

NPI: 1538019195
Provider Name (Legal Business Name): VIAMIND THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 NW 179TH TER
MIAMI GARDENS FL
33055-3247
US

IV. Provider business mailing address

4921 NW 179TH TER
MIAMI GARDENS FL
33055-3247
US

V. Phone/Fax

Practice location:
  • Phone: 786-659-3632
  • Fax: 786-788-8115
Mailing address:
  • Phone: 786-659-3632
  • Fax: 786-788-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAZARO SANTANA
Title or Position: OWNER
Credential:
Phone: 786-659-3632