Healthcare Provider Details

I. General information

NPI: 1780236414
Provider Name (Legal Business Name): BFS OF BOYNTON BEACH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 N CONGRESS AVE STE 311
BOYNTON BEACH FL
33426-8675
US

IV. Provider business mailing address

1880 N CONGRESS AVE STE 311
BOYNTON BEACH FL
33426-8675
US

V. Phone/Fax

Practice location:
  • Phone: 561-421-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. KYRA GONZALEZ
Title or Position: OWNER
Credential: BCBA
Phone: 561-421-5111