Organization
LB MINDFUL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYSSA BROOKS PMHNP (SOLE-MEMBER)
(954) 600-2756
Entity
Organization
Contact information
Practice address
7901 4TH ST N STE 300, SAINT PETERSBURG, FL 33702-4399
(561) 493-3212
Mailing address
980 N FEDERAL HWY STE 110, BOCA RATON, FL 33432-2704
(303) 285-1117
(720) 562-2940
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/01/2022
Last updated
01/30/2023
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