Healthcare Provider Details

I. General information

NPI: 1114861689
Provider Name (Legal Business Name): KIND MINDA MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10341 SW 122ND ST
MIAMI FL
33176-4713
US

IV. Provider business mailing address

10341 SW 122ND ST
MIAMI FL
33176-4713
US

V. Phone/Fax

Practice location:
  • Phone: 786-808-8771
  • Fax:
Mailing address:
  • Phone: 786-808-8771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GABRIELA PUIG
Title or Position: CEO
Credential: LCSW
Phone: 786-808-8771