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3117 Sw 13th Ct Fort Lauderdale FL 33312-2714 | |
| (954) 315-4041 | |
| (954) 315-4099 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3117 Sw 13th Ct, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Tamika L Lewis (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 7862518224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2700 W 81st St Hialeah FL 33016-2732 Ph: (305) 325-1080 | 3117 Sw 13th Ct Fort Lauderdale FL 33312-2714 Ph: (954) 315-4041 |
| NPI Number | 1871801928 |
|---|---|
| Provider Enumeration Date | 09/22/2010 |
| Last Update Date | 02/06/2024 |
| Certification Date | 12/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871801928 | NPI | - | NPPES |
| 019202200 | Medicaid | FL | |
| 880506700 | Medicaid | FL |
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