Organization
MMJ MINDFUL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LAZO PMHNP (PMHNP)
(786) 531-6462
Entity
Organization
Contact information
Practice address
1172 S DIXIE HWY, CORAL GABLES, FL 33146-2918
(305) 914-0386
Mailing address
1172 S DIXIE HWY, CORAL GABLES, FL 33146-2918
(305) 914-0386
(305) 914-0388
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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