Organization
MINDFUL BEHAVIORAL HEALTHCARE, LLC
Active
Organization
MINDFUL BEHAVIORAL HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MISSIGMAN (COO)
(352) 328-9139
Entity
Organization
Contact information
Practice address
717 E OAK ST, KISSIMMEE, FL 34744-4580
(407) 846-0533
(407) 518-1730
Mailing address
719 EAST OAK STREET, KISSIMMEE, FL 34744
(407) 846-0533
(407) 518-1730
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006520800
—
FL
05
—
019725400
—
FL
Enumeration date
08/05/2007
Last updated
01/26/2022
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