Healthcare Provider Details

I. General information

NPI: 1215869110
Provider Name (Legal Business Name): HOLISTIC HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 SW 118TH AVE
MIAMI FL
33175-2338
US

IV. Provider business mailing address

3180 SW 118TH AVE
MIAMI FL
33175-2338
US

V. Phone/Fax

Practice location:
  • Phone: 786-970-4029
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LARISA PEREZ ISASI
Title or Position: PRESIDENT
Credential: APRN
Phone: 786-970-4029