| Brain & Behavioral Institute Of South Florida Inc | |
|
1801 Coral Way Suite#327 Miami FL 33145-2790 | |
| (786) 866-5914 | |
| (786) 866-5928 |
| Full Name | Brain & Behavioral Institute Of South Florida Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1801 Coral Way, Miami, Florida |
| Authorized Official Name and Position | Williams Jose Lucena (PRESIDENT) |
| Authorized Official Contact | 7868665914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain & Behavioral Institute Of South Florida Inc 1801 Coral Way Suite# 327 Miami FL 33145-2790 Ph: (786) 866-5914 | Brain & Behavioral Institute Of South Florida Inc 1801 Coral Way Suite#327 Miami FL 33145-2790 Ph: (786) 866-5914 |
| NPI Number | 1831526151 |
|---|---|
| Provider Enumeration Date | 10/01/2013 |
| Last Update Date | 10/13/2021 |
| Certification Date | 10/13/2021 |
| Medicare PECOS PAC ID | 4880002344 |
|---|---|
| Medicare Enrollment ID | O20210421002417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831526151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| Provider Name | Ana J Solis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568495851 PECOS PAC ID: 4486643335 Enrollment ID: I20040507000158 |
| Provider Name | David Treto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447704796 PECOS PAC ID: 2860801354 Enrollment ID: I20210513001382 |
| Provider Name | Deborah Virgen Ibarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407359946 PECOS PAC ID: 5991185506 Enrollment ID: I20220629000374 |
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