Healthcare Provider Details

I. General information

NPI: 1194173757
Provider Name (Legal Business Name): CARLOS LAMADRID BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4793 N CONGRESS AVE STE 203
BOYNTON BEACH FL
33426-7937
US

IV. Provider business mailing address

4793 N CONGRESS AVE STE 203
BOYNTON BEACH FL
33426-7937
US

V. Phone/Fax

Practice location:
  • Phone: 561-722-9107
  • Fax: 561-448-6063
Mailing address:
  • Phone: 561-722-9107
  • Fax: 561-448-6063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-36146
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: