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General NPI Number Information
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NPI Number | 1023934924
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Entity Type | Organization
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Legal Business Name | MINDFUL PSYCHIATRY AND WEIGHT WELLNESS
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 4723 NW 53RD AVE STE B
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City | GAINESVILLE
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State | FL
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Zip | 32653-4804
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Country | US
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Telephone | 352-707-8188
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Fax | 352-743-1933
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Provider Business Mailing Address
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Address Line | 4723 NW 53RD AVE STE B
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City | GAINESVILLE
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State | FL
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Zip | 32653-4804
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Country | US
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Telephone | 352-707-8188
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Fax | 352-743-1933
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH GOLDBERG
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Credential | APRN
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Telephone | 352-494-6940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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