| |
6405 Nw 36th St Ste 123 Virginia Gardens FL 33166-6960 | |
(305) 397-3597 | |
(305) 675-8040 |
Full Name | |
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Speciality | Behavior Analyst |
Location | 6405 Nw 36th St Ste 123, Virginia Gardens, Florida |
Authorized Official Name and Position | Yanisleidys Trabado (PRESIDENT) |
Authorized Official Contact | 3053973597 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6405 Nw 36th St Ste 123 Virginia Gardens FL 33166-6960 Ph: (305) 397-3597 | 6405 Nw 36th St Ste 123 Virginia Gardens FL 33166-6960 Ph: (305) 397-3597 |
NPI Number | 1831502491 |
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Provider Enumeration Date | 06/11/2014 |
Last Update Date | 06/11/2024 |
Certification Date | 06/11/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831502491 | NPI | - | NPPES |
018713900 | Medicaid | FL | |
12052 | Other | FL | HEALTH CARE CLINIC |
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