| NPI | 1932780590 |
|---|---|
| Doing Business As | CRYSTAL MINDS MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ENIO REYES MIRANDA Owner 786-321-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 208D00000X General Practice |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2024-12-13 |