Healthcare Provider Details

I. General information

NPI: 1851064182
Provider Name (Legal Business Name): NIECAT FOUNDATION OF EXCELLENCE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16800 NW 17TH AVE
MIAMI GARDENS FL
33056-4904
US

IV. Provider business mailing address

14421 NW 13TH RD
MIAMI FL
33167-1110
US

V. Phone/Fax

Practice location:
  • Phone: 833-230-9366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIRIAM C SULLIVAN
Title or Position: CEO
Credential:
Phone: 305-761-5135