MEDICARE: THE BEHAVIOR BOX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003426123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BEHAVIOR BOX

Provider Business Mailing Address
First Line	:	230 NW 87TH AVE APT I215
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-4563
Country	:	US
Telephone Number	:	786-343-0813
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 NW 87TH AVE APT I215
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-4563
Country	:	US
Telephone Number	:	786-343-0813
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EDNEI ESTEVEZ
Credential	:	BCBA
Telephone Number	:	786-343-0813

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	12/13/2022

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Directions to “THE BEHAVIOR BOX ” Practice Location

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