MEDICARE: MINDFUL CARE SERVICES 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	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790408409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	5375 NW 7TH ST PH 859
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3795
Country	:	US
Telephone Number	:	305-764-0870
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 W 49TH ST STE 731
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2973
Country	:	US
Telephone Number	:	305-764-0870
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIELA CASTRO
Credential	:
Telephone Number	:	305-764-0870

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	01/26/2023

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