Healthcare Provider Details

I. General information

NPI: 1528916236
Provider Name (Legal Business Name): KREATIVE MINDS CORNER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 SEAGRAPE TER
MIAMI LAKES FL
33014-2930
US

IV. Provider business mailing address

6950 SEAGRAPE TER
MIAMI LAKES FL
33014-2930
US

V. Phone/Fax

Practice location:
  • Phone: 305-484-3163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KAYTLEN CUBA
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S. CCC-SLP
Phone: 305-484-3163