| Envision Mindcare | |
|
602 Ne 36th St Ste 19 Miami FL 33137-3917 | |
| (786) 220-1969 | |
| (786) 217-9604 |
| Full Name | Envision Mindcare |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 602 Ne 36th St Ste 19, Miami, Florida |
| Authorized Official Name and Position | Randy Warner (OWNER) |
| Authorized Official Contact | 3059123093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Envision Mindcare 602 Ne 36th St Ste 19 Miami FL 33137-3917 Ph: (786) 220-1969 | Envision Mindcare 602 Ne 36th St Ste 19 Miami FL 33137-3917 Ph: (786) 220-1969 |
| NPI Number | 1306615786 |
|---|---|
| Provider Enumeration Date | 12/27/2023 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Medicare PECOS PAC ID | 1153774997 |
|---|---|
| Medicare Enrollment ID | O20240129002914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306615786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Maria C Botero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831600451 PECOS PAC ID: 4688911167 Enrollment ID: I20190122001606 |
| Provider Name | Lourdes E Velazquez Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801494224 PECOS PAC ID: 3779984869 Enrollment ID: I20210628000480 |
| Provider Name | Shamilah Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497335699 PECOS PAC ID: 9032582309 Enrollment ID: I20230307002347 |
| Provider Name | Yumays Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508645391 PECOS PAC ID: 4385092857 Enrollment ID: I20231121002936 |
| Provider Name | Randy Warner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144380056 PECOS PAC ID: 5294712279 Enrollment ID: I20240129004608 |
| Provider Name | Amy Riche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518735570 PECOS PAC ID: 7719325034 Enrollment ID: I20240405001862 |
| Provider Name | Margarita Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770340846 PECOS PAC ID: 9739529991 Enrollment ID: I20240504000266 |
| Provider Name | Dianelys Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336907591 PECOS PAC ID: 0941640114 Enrollment ID: I20240505000083 |
| Provider Name | Lemoya Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558135822 PECOS PAC ID: 9638510209 Enrollment ID: I20240514001275 |
| Provider Name | Laura Pinero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376240762 PECOS PAC ID: 5496197253 Enrollment ID: I20240524000154 |
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