# MINDFUL RETREAT WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679483788
- **Authorized official:** BILLY LESPERANCE APRN,PMHNP-C (OWNER)
- **Authorized official phone:** (954) 856-4567

## Contact information

- **Practice address:** 3571 SW 93RD AVE, MIRAMAR, FL 33025-1746
- **Practice address phone:** (954) 856-4567
- **Mailing address:** 3571 SW 93RD AVE, MIRAMAR, FL 33025-1746
- **Mailing address phone:** (954) 856-4567

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2026
- **Last updated:** 09/10/2026