Healthcare Provider Details

I. General information

NPI: 1962202689
Provider Name (Legal Business Name): K&T HARMONY WELLNESS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FONTAINEBLEAU BLVD STE 1R10
MIAMI FL
33172-4511
US

IV. Provider business mailing address

175 FONTAINEBLEAU BLVD STE 1R10
MIAMI FL
33172-4511
US

V. Phone/Fax

Practice location:
  • Phone: 305-479-8611
  • Fax: 850-616-0498
Mailing address:
  • Phone: 305-479-8611
  • Fax: 850-616-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TANIA TRUJILLO
Title or Position: OWNER
Credential:
Phone: 786-879-3264