=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598586620
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTHY FUTURE CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2024
-----------------------------------------------------
Last Update Date | 08/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10695 BEACH BLVD STE 3
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32246-0821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 754-305-8321
-----------------------------------------------------
Fax | 213-577-2014
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10695 BEACH BLVD STE 3
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32246-0821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 754-305-8321
-----------------------------------------------------
Fax | 213-577-2014
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JORGE L DIAZ ACOSTA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-663-6765
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------