Healthcare Provider Details

I. General information

NPI: 1356869622
Provider Name (Legal Business Name): LIGHTING BEHAVIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 NW 167TH ST
MIAMI LAKES FL
33014-6426
US

IV. Provider business mailing address

4800 NW 167TH ST
MIAMI LAKES FL
33014-6426
US

V. Phone/Fax

Practice location:
  • Phone: 305-515-2726
  • Fax: 786-723-3579
Mailing address:
  • Phone: 305-515-2726
  • Fax: 786-723-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNABELLY LUIS
Title or Position: OWNER
Credential:
Phone: 305-515-2726