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General NPI Number Information
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NPI Number | 1689248064
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Entity Type | Organization
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Legal Business Name | HEAVENLY SOUL'S CARE
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 08/06/2021
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Provider Practice Location Address
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Address Line | 13000 NE 12TH AVE
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4305
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Country | US
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Telephone | 786-999-9909
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Fax |
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Provider Business Mailing Address
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Address Line | 16756 NE 4TH CT
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3975
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Country | US
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Telephone | 786-999-9909
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROSIE MICHEL
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Credential | PMHNP-BC
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Telephone | 786-999-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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