Healthcare Provider Details

I. General information

NPI: 1649100181
Provider Name (Legal Business Name): DOOR TO THE SOUL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10471 N KENDALL DR STE E105
MIAMI FL
33176-8714
US

IV. Provider business mailing address

29995 SW 157TH PL
HOMESTEAD FL
33033-2420
US

V. Phone/Fax

Practice location:
  • Phone: 786-370-2216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: GISELLE LOBAINA FERNENDEZ RUBIO
Title or Position: MGR
Credential: BCBA
Phone: 786-370-2216