Healthcare Provider Details

I. General information

NPI: 1487407268
Provider Name (Legal Business Name): ICARE MENTAL HEALTH AND WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8532 SW 8TH ST STE 290
MIAMI FL
33144-4054
US

IV. Provider business mailing address

12891 SW 62ND LN
MIAMI FL
33183-5450
US

V. Phone/Fax

Practice location:
  • Phone: 786-927-8048
  • Fax: 786-504-7034
Mailing address:
  • Phone: 786-370-3039
  • Fax: 786-370-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ISMEL FERNANDEZ-CALIENES
Title or Position: PRESIDENT
Credential:
Phone: 786-370-3039