Healthcare Provider Details

I. General information

NPI: 1508775388
Provider Name (Legal Business Name): SHEYLAH MOLA APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14221 SW 120TH ST STE 221
MIAMI FL
33186-4225
US

IV. Provider business mailing address

3382 SW 153RD PL
MIAMI FL
33185-4840
US

V. Phone/Fax

Practice location:
  • Phone: 786-281-2588
  • Fax:
Mailing address:
  • Phone: 786-281-2588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11050778
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: