Healthcare Provider Details

I. General information

NPI: 1013226141
Provider Name (Legal Business Name): JILLIAN MEHLER MT-BC,NMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10725 SW 104TH ST
MIAMI FL
33176-8162
US

IV. Provider business mailing address

800 WEST AVE # 1033
MIAMI BEACH FL
33139-5542
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-7883
  • Fax: 305-274-4271
Mailing address:
  • Phone: 305-528-5836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number08038
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: