Healthcare Provider Details

I. General information

NPI: 1902723851
Provider Name (Legal Business Name): TORUS MIND AND MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 SE OSCEOLA ST UNIT 2
STUART FL
34994-2505
US

IV. Provider business mailing address

421 SE OSCEOLA ST UNIT 2
STUART FL
34994-2505
US

V. Phone/Fax

Practice location:
  • Phone: 561-504-9882
  • Fax: 561-504-9882
Mailing address:
  • Phone: 561-504-9882
  • Fax: 561-504-9882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/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
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARI E SAMSON
Title or Position: OWNER
Credential: MD
Phone: 561-504-9882