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General NPI Number Information
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NPI Number | 1720987761
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Entity Type | Organization
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Legal Business Name | MIAMI MENTAL HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 101925 OVERSEAS HWY UNIT 109
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City | KEY LARGO
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State | FL
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Zip | 33037-4586
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Country | US
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Telephone | 786-937-9835
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Fax | 786-937-9834
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Provider Business Mailing Address
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Address Line | 9835 SUNSET DR STE 105
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City | MIAMI
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State | FL
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Zip | 33173-4648
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Country | US
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Telephone | 786-937-9835
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Fax | 786-937-9834
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Authorized Official
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Title or Position | CEO
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Name | ALEJANDRO DE LA PORTILLA
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Credential |
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Telephone | 786-797-2051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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