Healthcare Provider Details

I. General information

NPI: 1497534390
Provider Name (Legal Business Name): THUNDER MINDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13180 N CLEVELAND AVE STE 313
NORTH FORT MYERS FL
33903-6231
US

IV. Provider business mailing address

13180 N CLEVELAND AVE STE 313
NORTH FORT MYERS FL
33903-6231
US

V. Phone/Fax

Practice location:
  • Phone: 239-895-5014
  • Fax:
Mailing address:
  • Phone: 239-895-5014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: JUDITH FERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 239-895-5014