Organization
MINDFUL CONNECTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN D GALLOSO LCSW, CAP, ACHT (OWNER / PRESIDENT)
(954) 770-2363
Entity
Organization
Contact information
Practice address
3042 N FEDERAL HWY, SUITE 207, FORT LAUDERDALE, FL 33306-1400
(954) 770-2363
Mailing address
733 NW 30TH CT, UNIT # 7, WILTON MANORS, FL 33311-2400
(954) 770-2363
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
SW8346
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010912100
—
FL
Enumeration date
06/06/2014
Last updated
06/06/2014
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