MEDICARE: TINY MIRACLES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1083579627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TINY MIRACLES, LLC

Provider Business Mailing Address
First Line	:	1401 VILLAGE BLVD APT 1115
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-2766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 VILLAGE BLVD APT 1115
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-2766
Country	:	US
Telephone Number	:	850-566-2466
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICAL DIRECTOR
Name	:	RENEISHA DRAYTON
Credential	:
Telephone Number	:	850-566-2466

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “TINY MIRACLES, LLC ” Practice Location

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