| 1st Jpa Behavior Management Clinic Inc | |
|
19001 Sw 106th Ave Suite C103 Cutler Bay FL 33157-7669 | |
| (786) 523-2352 | |
| (786) 431-4078 |
| Full Name | 1st Jpa Behavior Management Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19001 Sw 106th Ave, Cutler Bay, Florida |
| Authorized Official Name and Position | Amarilys Perez (PRESIDENT) |
| Authorized Official Contact | 7862007425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 1st Jpa Behavior Management Clinic Inc 19001 Sw 106th Ave Suite C103 Cutler Bay FL 33157-7669 Ph: (786) 523-2352 | 1st Jpa Behavior Management Clinic Inc 19001 Sw 106th Ave Suite C103 Cutler Bay FL 33157-7669 Ph: (786) 523-2352 |
| NPI Number | 1972903524 |
|---|---|
| Provider Enumeration Date | 09/02/2014 |
| Last Update Date | 10/15/2020 |
| Certification Date | 10/15/2020 |
| Medicare PECOS PAC ID | 1759695745 |
|---|---|
| Medicare Enrollment ID | O20150804005923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972903524 | NPI | - | NPPES |
| 014923500 | Medicaid | FL | |
| 014923501 | Medicaid | FL | |
| 018511200 | Medicaid | FL |
| Provider Name | Jose C Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669515730 PECOS PAC ID: 8325959117 Enrollment ID: I20031113000680 |
| Provider Name | Carlos A Ripoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558751099 PECOS PAC ID: 7214034404 Enrollment ID: I20151014001048 |
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