Healthcare Provider Details

I. General information

NPI: 1003400573
Provider Name (Legal Business Name): INNOVATIVE SOLUTIONS AND CONSULTING FIRM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2021
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 SW 132ND ST STE 205A
MIAMI FL
33186-6224
US

IV. Provider business mailing address

12955 SW 132ND ST STE 205A
MIAMI FL
33186-6224
US

V. Phone/Fax

Practice location:
  • Phone: 305-964-7917
  • Fax: 305-675-9211
Mailing address:
  • Phone: 305-964-7917
  • Fax: 305-675-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GERMAN A ALFARO
Title or Position: PRESIDENT/CEO
Credential: LMHC
Phone: 305-964-7917