Healthcare Provider Details

I. General information

NPI: 1972117000
Provider Name (Legal Business Name): LAURA ALICIA BESADA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2020
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7959 NW 2ND ST STE A
MIAMI FL
33126-8000
US

IV. Provider business mailing address

7959 NW 2ND ST STE A
MIAMI FL
33126-8000
US

V. Phone/Fax

Practice location:
  • Phone: 786-356-1123
  • Fax: 540-408-0205
Mailing address:
  • Phone: 954-335-5541
  • Fax: 540-408-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11009147
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: