MEDICARE: ENVISION MINDCARE

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1306615786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENVISION MINDCARE

Provider Business Mailing Address
First Line	:	3000 BISCAYNE BLVD STE 216
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-4129
Country	:	US
Telephone Number	:	786-220-1969
Fax Number	:	786-217-9604

Provider Business Practice Location Address
First Line	:	3000 BISCAYNE BLVD STE 216
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-4129
Country	:	US
Telephone Number	:	786-220-1969
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RANDY WARNER
Credential	:	MD
Telephone Number	:	305-912-3093

Provider Enumeration Date	:	12/27/2023
Last Update Date	:	12/03/2024

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Directions to “ENVISION MINDCARE ” Practice Location

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