Healthcare Provider Details

I. General information

NPI: 1144514035
Provider Name (Legal Business Name): CLAUDIA CAMPOS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 NW 79TH AVE SUITE 501
DORAL FL
33166-6556
US

IV. Provider business mailing address

7320 SW 37TH ST
MIAMI FL
33155-6602
US

V. Phone/Fax

Practice location:
  • Phone: 305-597-3861
  • Fax: 305-597-3863
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-16031
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: