Healthcare Provider Details

I. General information

NPI: 1326353780
Provider Name (Legal Business Name): MY BIG WORLD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 SW 135TH AVE
MIAMI FL
33175-3817
US

IV. Provider business mailing address

8785 SW 165TH AVE STE 101
MIAMI FL
33193-5827
US

V. Phone/Fax

Practice location:
  • Phone: 786-234-4977
  • Fax: 305-225-0270
Mailing address:
  • Phone: 305-388-0004
  • Fax: 305-388-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. MARLENE TAPANES
Title or Position: DIRECTOR
Credential:
Phone: 53-766-7378