MEDICARE: BEHAVIOR KEY THERAPY INC

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	:	1831803105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR KEY THERAPY INC

Provider Business Mailing Address
First Line	:	1275 W 47TH PL STE 324
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3449
Country	:	US
Telephone Number	:	786-506-2645
Fax Number	:

Provider Business Practice Location Address
First Line	:	1275 W 47TH PL STE 324
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3449
Country	:	US
Telephone Number	:	786-506-2645
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YENNY BALLESTEROS TORRES
Credential	:	BCBA
Telephone Number	:	786-908-7371

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	05/03/2023

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