Healthcare Provider Details

I. General information

NPI: 1467993733
Provider Name (Legal Business Name): HEALING MEDICAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 NE MIAMI GARDENS DR STE 130
NORTH MIAMI BEACH FL
33179-4707
US

IV. Provider business mailing address

1380 NE MIAMI GARDENS DR STE 130
NORTH MIAMI BEACH FL
33179-4707
US

V. Phone/Fax

Practice location:
  • Phone: 561-507-8877
  • Fax: 954-204-0464
Mailing address:
  • Phone: 561-507-8877
  • Fax: 954-204-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberME114179
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT2904
License Number StateFL

VIII. Authorized Official

Name: CATHY PICILLO
Title or Position: BILLING MANAGER
Credential:
Phone: 954-234-2469