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Organization

MINDSCOPE CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CAROLINA HENAO IRURITA PH.D (LICENSED PSYCHOLOGIST)
(321) 287-0325
Entity
Organization

Contact information

Practice address
3680 AVALON PARK EAST BLVD STE 203, ORLANDO, FL 32828-9372
(321) 340-3038
(407) 604-6671
Mailing address
12425 MARLEIGH CT, ORLANDO, FL 32828-8650

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
09/20/2023
Last updated
05/01/2025
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