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General NPI Number Information
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NPI Number | 1942937271
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Entity Type | Organization
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Legal Business Name | LB MENTAL HEALTH, INC
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 3302 W 97TH TER
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City | HIALEAH
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State | FL
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Zip | 33018-2044
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Country | US
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Telephone | 786-356-1123
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Fax |
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Provider Business Mailing Address
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Address Line | 3302 W 97TH TER
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City | HIALEAH
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State | FL
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Zip | 33018-2044
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Country | US
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Telephone | 786-356-1123
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | LAURA ALICIA BESADA
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Credential | PMHNP-BC
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Telephone | 786-356-1123
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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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