Healthcare Provider Details

I. General information

NPI: 1053770388
Provider Name (Legal Business Name): BARACUSA HEALTH CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/03/2024
Certification Date: 02/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7235 SW 24TH ST SUITE 204
MIAMI FL
33155-1466
US

IV. Provider business mailing address

7235 SW 24TH ST SUITE 204
MIAMI FL
33155-1466
US

V. Phone/Fax

Practice location:
  • Phone: 786-452-0257
  • Fax: 786-536-9248
Mailing address:
  • Phone: 786-452-0257
  • Fax: 786-536-9248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BELKYS CORRALES
Title or Position: OWNER
Credential: RN
Phone: 786-452-0257