=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275248031
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALI TRANSFORMATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2023
-----------------------------------------------------
Last Update Date | 01/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 BRICKELL KEY DR STE 700
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33131-2649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-509-4888
-----------------------------------------------------
Fax | 786-705-6912
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 843 MERIDIAN AVE APT 3
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33139-5734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-509-4888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. GAIL A WINT
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 561-509-4888
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------