Healthcare Provider Details

I. General information

NPI: 1831820695
Provider Name (Legal Business Name): PUZZLE THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 11/11/2023
Certification Date: 11/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 DEL PRADO BLVD S STE 201
CAPE CORAL FL
33990-3601
US

IV. Provider business mailing address

1003 DEL PRADO BLVD S STE 201
CAPE CORAL FL
33990-3601
US

V. Phone/Fax

Practice location:
  • Phone: 239-221-3817
  • Fax: 786-796-1029
Mailing address:
  • Phone: 239-221-3817
  • Fax: 786-796-1029

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 Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MANUEL RODRIGUEZ
Title or Position: PRESIDENT
Credential: BCBA
Phone: 786-765-8232