MEDICARE: VENTURA DE JESUS GARCIA PRADO

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	106S00000X	Behavior Technician	RBT-19-95076	FL
2	103K00000X	Behavior Analyst	BCBA-1-24-76665	FL

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	:	1053968446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VENTURA DE JESUS GARCIA PRADO

Provider Business Mailing Address
First Line	:	6145 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-6472
Country	:	US
Telephone Number	:	786-828-2604
Fax Number	:

Provider Business Practice Location Address
First Line	:	5506 SW 134TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6142
Country	:	US
Telephone Number	:	786-828-2604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	08/22/2025

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