Healthcare Provider Details

I. General information

NPI: 1831050004
Provider Name (Legal Business Name): MIAMI HEALTH & KULTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14221 SW 120TH ST STE 208
MIAMI FL
33186-4224
US

IV. Provider business mailing address

14221 SW 120TH ST STE 208
MIAMI FL
33186-4224
US

V. Phone/Fax

Practice location:
  • Phone: 786-359-4949
  • Fax: 786-542-5184
Mailing address:
  • Phone: 786-359-4949
  • Fax: 786-542-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LISSETT MARIN
Title or Position: OWNER
Credential:
Phone: 786-359-4949