Healthcare Provider Details

I. General information

NPI: 1811850142
Provider Name (Legal Business Name): MMGBEHAVIORAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 NW 10TH AVE APT 308
MIAMI FL
33127-4075
US

IV. Provider business mailing address

2505 NW 10TH AVE APT 308
MIAMI FL
33127-4075
US

V. Phone/Fax

Practice location:
  • Phone: 786-370-5358
  • Fax:
Mailing address:
  • Phone: 786-370-5358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARTHA MACHADO GARCIA
Title or Position: PRESIDENT
Credential: RMHCI
Phone: 786-370-5358