Healthcare Provider Details

I. General information

NPI: 1962306555
Provider Name (Legal Business Name): INTEGRATIVE MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 NE MIAMI GARDENS DR APT 243
MIAMI FL
33179-4884
US

IV. Provider business mailing address

1501 NE MIAMI GARDENS DR APT 243
MIAMI FL
33179-4884
US

V. Phone/Fax

Practice location:
  • Phone: 918-853-3067
  • Fax:
Mailing address:
  • Phone: 918-853-3067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ABRAHAM ASHTON
Title or Position: CEO/MANAGER
Credential: DNP
Phone: 918-853-3067