Healthcare Provider Details

I. General information

NPI: 1578476362
Provider Name (Legal Business Name): MIND INSIGHT PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4933 SW 139TH CT
MIAMI FL
33175-0917
US

IV. Provider business mailing address

4933 SW 139TH CT
MIAMI FL
33175-0917
US

V. Phone/Fax

Practice location:
  • Phone: 786-444-9956
  • Fax:
Mailing address:
  • Phone: 786-444-9956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: REBECA EVORA MIRO
Title or Position: OWNER
Credential: PSY.D., BCBA
Phone: 786-444-9956