MEDICARE: ONE MIND WELLNESS & KETAMINE

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	:	1508719642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE MIND WELLNESS & KETAMINE

Provider Business Mailing Address
First Line	:	6000 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2226
Country	:	US
Telephone Number	:	954-953-3516
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CO-FOUNDER
Name	:	MICHAEL TERMENA
Credential	:
Telephone Number	:	954-953-3516

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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