MEDICARE: MINDFUL VIDA INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	261QH0100X	Health Service Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1730913567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL VIDA INC

Provider Business Mailing Address
First Line	:	7850 BYRON AVE APT 904
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-2096
Country	:	US
Telephone Number	:	305-763-1953
Fax Number	:

Provider Business Practice Location Address
First Line	:	7850 BYRON AVE APT 904
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-2096
Country	:	US
Telephone Number	:	305-763-1953
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ERIKA ESTEFANIA ACOSTA
Credential	:	MS, LMHC
Telephone Number	:	305-763-1953

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	09/07/2024

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Directions to “MINDFUL VIDA INC ” Practice Location

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