Organization · NPI-2

Beautiful Mind Clinic, LLC

Psychiatry & Neurology, Neurology · Orlando, FL

NPI number1184190753
StatusActive
Last updated in NPPESDec 23, 2020

Details

NPI
1184190753
Entity type
Organization (NPI-2)
Legal business name
Beautiful Mind Clinic, LLC
Organization subpart
No
Enumeration date
Oct 22, 2018
Certification date
Dec 23, 2020
Last updated
Dec 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology––Yes

Practice location

7208 W Sand Lake Rd Ste 305
Orlando, FL 32819-5279

Phone 407-799-8808 · Fax 407-440-4307

Mailing address

7208 W Sand Lake Rd Ste 305
Orlando, FL 32819-5279

Phone 407-799-8808

Authorized official

Damon Lai
Healthcare Administrator
4077998808

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