Healthcare Provider Details

I. General information

NPI: 1790699593
Provider Name (Legal Business Name): MENTAL WEALTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4630 SW 151ST TER
MIRAMAR FL
33027-3652
US

IV. Provider business mailing address

4630 SW 151ST TER
MIRAMAR FL
33027-3652
US

V. Phone/Fax

Practice location:
  • Phone: 954-266-8023
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JASLYN DECASO
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 954-830-3831