| Azul Mindspace Llc | |
|
10631 Habitat Trl Bokeelia FL 33922-3122 | |
| (786) 505-4022 | |
| Not Available |
| Full Name | Azul Mindspace Llc |
|---|---|
| Speciality | Psychologist |
| Location | 10631 Habitat Trl, Bokeelia, Florida |
| Authorized Official Name and Position | Michelle Renee White (PSYCHOLOGIST / OWNER) |
| Authorized Official Contact | 7865054022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azul Mindspace Llc 10631 Habitat Trl Bokeelia FL 33922-3122 Ph: (786) 505-4022 | Azul Mindspace Llc 10631 Habitat Trl Bokeelia FL 33922-3122 Ph: (786) 505-4022 |
| NPI Number | 1508648072 |
|---|---|
| Provider Enumeration Date | 10/18/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 7911353941 |
|---|---|
| Medicare Enrollment ID | O20231027001925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508648072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle Renee White |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1609988732 PECOS PAC ID: 7416045737 Enrollment ID: I20230612000003 |
Balance Becomes You L.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13960 Stringfellow Rd, Bokeelia, FL 33922 Phone: 716-204-6978 | |
Center For Life Changing Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10651 Habitat Trl, Bokeelia, FL 33922 Phone: 239-247-2327 |