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General NPI Number Information
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NPI Number | 1366338535
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Entity Type | Organization
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Legal Business Name | THE MIND GYM, INC.
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 11367 SW 248TH TER
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City | PRINCETON
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State | FL
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Zip | 33032-3442
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Country | US
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Telephone | 786-879-5355
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Fax | 786-879-5355
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Provider Business Mailing Address
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Address Line | 3111 NW 2ND ST
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City | MIAMI
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State | FL
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Zip | 33125-5011
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Country | US
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Telephone | 786-592-0057
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MILAGROS D MALDONADO
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Credential | LMHC
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Telephone | 786-879-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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