Healthcare Provider Details

I. General information

NPI: 1093497646
Provider Name (Legal Business Name): SMILING SIMPLE STEPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 SE 6TH AVE APT 206H
DEERFIELD BEACH FL
33441-6965
US

IV. Provider business mailing address

1261 SE 6TH AVE APT 206H
DEERFIELD BEACH FL
33441-6965
US

V. Phone/Fax

Practice location:
  • Phone: 979-257-7906
  • Fax:
Mailing address:
  • Phone: 979-257-7906
  • 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: MR. FRANK ERNESTO HERNANDEZ
Title or Position: OWNER
Credential:
Phone: 979-257-7906