=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770905572
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FLORIDA MENTAL HEALTH PRACTITIONERS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2014
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7221 CORAL WAY STE 206
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33155-1436
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-648-4447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 934878
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33093-4878
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-648-4447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT / OWNER
-----------------------------------------------------
Name | DR. YOLANDA GONZALEZ
-----------------------------------------------------
Credential | LMHC, PSYD
-----------------------------------------------------
Telephone | 786-648-4447
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MH11901
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------