Healthcare Provider Details

I. General information

NPI: 1558021980
Provider Name (Legal Business Name): POSITIVE BEHAVIOR HEALTH DEVELOPMENTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 PONCE DE LEON BLVD STE 300
CORAL GABLES FL
33134-6044
US

IV. Provider business mailing address

400 N ASHLEY DR STE 1900
TAMPA FL
33602-4311
US

V. Phone/Fax

Practice location:
  • Phone: 888-343-7222
  • Fax: 888-791-0181
Mailing address:
  • Phone: 888-343-7222
  • Fax: 888-791-0181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ROSA KUCHLING
Title or Position: CLIENT RELATIONS MANAGER
Credential: RBT
Phone: 888-343-7222