| Harmonious Minds Llc | |
|
4300 N University Dr Ste A106 Lauderhill FL 33351-6243 | |
| (954) 613-6007 | |
| Not Available |
| Full Name | Harmonious Minds Llc |
|---|---|
| Speciality | Counselor |
| Location | 4300 N University Dr Ste A106, Lauderhill, Florida |
| Authorized Official Name and Position | Jonquil Crowoll-fonseca (OWNER) |
| Authorized Official Contact | 7542187582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harmonious Minds Llc 4300 N University Dr Ste A106 Lauderhill FL 33351-6243 Ph: (954) 613-6007 | Harmonious Minds Llc 4300 N University Dr Ste A106 Lauderhill FL 33351-6243 Ph: (954) 613-6007 |
| NPI Number | 1487361796 |
|---|---|
| Provider Enumeration Date | 11/07/2022 |
| Last Update Date | 11/07/2022 |
| Certification Date | 04/19/2022 |
| Medicare PECOS PAC ID | 1557706322 |
|---|---|
| Medicare Enrollment ID | O20240302000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487361796 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Mark Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497183404 PECOS PAC ID: 4880050228 Enrollment ID: I20230510000827 |
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