Healthcare Provider Details

I. General information

NPI: 1518803006
Provider Name (Legal Business Name): MINDFUL INTERVENTION RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 SW 157TH AVE STE 5
MIAMI FL
33185-5349
US

IV. Provider business mailing address

5420 SW 157TH AVE STE 5
MIAMI FL
33185-5349
US

V. Phone/Fax

Practice location:
  • Phone: 305-225-0444
  • Fax: 305-225-0448
Mailing address:
  • Phone: 305-225-0444
  • Fax: 305-225-0448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: VICKY MIR RODRIGUEZ
Title or Position: OWNER
Credential:
Phone: 305-225-0444