Healthcare Provider Details

I. General information

NPI: 1407204985
Provider Name (Legal Business Name): DEVELOPING WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10689 N KENDALL DR STE 314
MIAMI FL
33176-1525
US

IV. Provider business mailing address

10689 N KENDALL DR STE 314
MIAMI FL
33176-1525
US

V. Phone/Fax

Practice location:
  • Phone: 786-703-5921
  • Fax: 786-536-6225
Mailing address:
  • Phone: 786-703-5921
  • Fax: 786-536-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LETICIA VICTORIA HERNANDEZ
Title or Position: OWNER
Credential:
Phone: 786-703-5921