=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366315913
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUMINOUS MENTAL HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2025
-----------------------------------------------------
Last Update Date | 09/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9555 SW 175TH TER
-----------------------------------------------------
City | PALMETTO BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-5604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-322-2811
-----------------------------------------------------
Fax | 786-550-2493
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15860 SW 147TH LN
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33196-6741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-322-2811
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ASTRID MONROE
-----------------------------------------------------
Credential | PMHNP-BC, PMH-C, FNP
-----------------------------------------------------
Telephone | 786-322-2811
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------