Healthcare Provider Details

I. General information

NPI: 1619528791
Provider Name (Legal Business Name): BIAA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 SE 4TH AVE STE B
FT LAUDERDALE FL
33316-1900
US

IV. Provider business mailing address

316 SE 7TH AVE
DEERFIELD BEACH FL
33441-4824
US

V. Phone/Fax

Practice location:
  • Phone: 954-696-6874
  • Fax: 305-705-3236
Mailing address:
  • Phone: 954-696-6874
  • Fax: 305-705-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BARBARA RIVERO-NODAL
Title or Position: OWNER
Credential: LMHC
Phone: 954-696-6874