Healthcare Provider Details

I. General information

NPI: 1043174717
Provider Name (Legal Business Name): MIND LINK MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11098 BISCAYNE BLVD STE 401
MIAMI FL
33161-7491
US

IV. Provider business mailing address

19001 NE 14TH AVE APT 211
MIAMI FL
33179-4049
US

V. Phone/Fax

Practice location:
  • Phone: 786-547-3550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA BOTERO
Title or Position: APRN
Credential: APRN
Phone: 786-547-3550