MEDICARE: ROYAL BEHAVIORAL SERVICES LLC

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

General Provider Information

NPI Number	:	1003674979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL BEHAVIORAL SERVICES LLC

Provider Business Mailing Address
First Line	:	3119 CORAL WAY STE 3121B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3294
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3119 CORAL WAY STE 3121B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3294
Country	:	US
Telephone Number	:	786-360-3213
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MIGUEL VILLEGAS
Credential	:
Telephone Number	:	786-360-3213

Provider Enumeration Date	:	03/06/2024
Last Update Date	:	09/17/2024

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