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Organization

VYTALYZE MINDS CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OSVALDO LEON HERRERA (P)
(305) 363-4001
Entity
Organization

Contact information

Practice address
2300 W 84TH ST STE 601, HIALEAH, FL 33016-5780
(305) 363-4001
(305) 363-4002
Mailing address
2300 W 84TH ST STE 601, MIAMI LAKES, FL 33016-5780
(305) 363-4001
(305) 363-4002

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
251B00000X
Case Management Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107794500
FL
01
12488
AHCA
FL
01
672191
JCAHO
FL
Enumeration date
08/16/2020
Last updated
02/28/2025
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