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General NPI Number Information
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NPI Number | 1952055964
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Entity Type | Organization
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Legal Business Name | MIRACLES OF THE HEART INC
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 7815 CORAL WAY STE 106-108
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City | MIAMI
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State | FL
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Zip | 33155-6541
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Country | US
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Telephone | 786-556-1397
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Fax |
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Provider Business Mailing Address
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Address Line | 15668 SW 72ND ST
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City | MIAMI
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State | FL
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Zip | 33193-1923
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Country | US
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Telephone | 786-315-6818
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BRISAIDA DUARTE
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Credential | PRESIDENT
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Telephone | 786-315-6818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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