MEDICARE: BEQUAL, CO

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	106E00000X	Assistant Behavior Analyst
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1912513862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEQUAL, CO

Provider Business Mailing Address
First Line	:	6445 INDIAN CREEK DR APT 304
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-5809
Country	:	US
Telephone Number	:	305-497-7241
Fax Number	:

Provider Business Practice Location Address
First Line	:	6445 INDIAN CREEK DR APT 304
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-5809
Country	:	US
Telephone Number	:	305-497-7241
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AMANDA ALBA RIVERO
Credential	:
Telephone Number	:	305-497-7241

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	03/14/2024

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Directions to “BEQUAL, CO ” Practice Location

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