Organization
MIND-BODY OPTIMAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERROT BADIO APRN (PRESIDENT/MANAGER)
(305) 215-1765
Entity
Organization
Contact information
Practice address
2321 RIVERDALE DR N, MIRAMAR, FL 33025-3821
(305) 215-1765
Mailing address
2321 RIVERDALE DR N, MIRAMAR, FL 33025-3821
(305) 215-1765
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275060287
FLORIDA
FL
Enumeration date
10/29/2021
Last updated
10/29/2021
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