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General NPI Number Information
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NPI Number | 1841989399
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Entity Type | Organization
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Legal Business Name | DRIVEN MENTALITY LLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 6925 LAKE ELLENOR DR STE 120
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City | ORLANDO
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State | FL
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Zip | 32809-4648
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Country | US
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Telephone | 407-301-1845
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Fax |
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Provider Business Mailing Address
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Address Line | 6925 LAKE ELLENOR DR STE 120
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City | ORLANDO
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State | FL
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Zip | 32809-4648
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Country | US
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Telephone | 407-301-1845
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DIANA CAROLINA ABRIL-MEDINA
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Credential |
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Telephone | 407-301-1845
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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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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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