Organization · NPI-2

A Mindfulness Space

Clinic/Center, Adult Mental Health · St Petersburg, FL

NPI number1073357745
StatusActive
Last updated in NPPESJun 19, 2024

Details

NPI
1073357745
Entity type
Organization (NPI-2)
Legal business name
A Mindfulness Space
Organization subpart
No
Enumeration date
Jun 19, 2024
Certification date
Jun 19, 2024
Last updated
Jun 19, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

7901 4th St N Ste 18631
St Petersburg, FL 33702-4305

Phone 386-961-4006 · Fax 402-235-4945

Mailing address

7901 4th St N Ste 18631
St Petersburg, FL 33702-4305

Authorized official

Virmarie Diaz Fernandez
Psychiatrist/Owner
3523396299

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