Healthcare Provider Details

I. General information

NPI: 1326917436
Provider Name (Legal Business Name): RESILIENT MIND MENTAL HEALTH & BEHAVIORAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 N. MAGNOLIA AVE SUITE 222
ORLANDO FL
32803
US

IV. Provider business mailing address

16009 ST CLAIR ST
CLERMONT FL
34714-6515
US

V. Phone/Fax

Practice location:
  • Phone: 352-782-2449
  • Fax:
Mailing address:
  • Phone: 352-782-2449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDDIE FIGUEROA
Title or Position: VICE-PRESIDENT
Credential:
Phone: 941-218-7227