Organization
CRYSTAL MINDS MENTAL HEALTH, LLC
Active
Other names
Crystal Minds Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
ENIO REYES MIRANDA (OWNER)
(786) 321-1600
Entity
Organization
Contact information
Practice address
8370 W FLAGLER ST STE 242, MIAMI, FL 33144-2040
(786) 321-1600
(786) 744-7937
Mailing address
1315 SW 94TH CT, MIAMI, FL 33174-3072
(786) 307-1876
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
12/13/2024
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