MEDICARE: APPLIED BEHAVIOR CARE 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	:	1073038931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLIED BEHAVIOR CARE LLC

Provider Business Mailing Address
First Line	:	13810 SW 42ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3781
Country	:	US
Telephone Number	:	786-543-5137
Fax Number	:

Provider Business Practice Location Address
First Line	:	9735 SW 138TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-7335
Country	:	US
Telephone Number	:	786-543-5137
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL SUAREZ
Credential	:	PH.D.
Telephone Number	:	786-543-5137

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	08/11/2017

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