MEDICARE: MY ANGEL THERAPY'S CORP.

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1205664729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY ANGEL THERAPY'S CORP.

Provider Business Mailing Address
First Line	:	3446 SW 8TH ST STE 217
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4142
Country	:	US
Telephone Number	:	786-769-5046
Fax Number	:

Provider Business Practice Location Address
First Line	:	3446 SW 8TH ST STE 217
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4142
Country	:	US
Telephone Number	:	786-769-5046
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	NAILET HERNANDEZ
Credential	:
Telephone Number	:	786-769-5046

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	10/01/2024

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Directions to “MY ANGEL THERAPY'S CORP. ” Practice Location

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