Healthcare Provider Details

I. General information

NPI: 1114765302
Provider Name (Legal Business Name): HEALTHY BEHAVIOR CHANGES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 NW 57TH AVE APT 208
MIAMI FL
33126
US

IV. Provider business mailing address

6800 BIRD RD STE 110
MIAMI FL
33155-3708
US

V. Phone/Fax

Practice location:
  • Phone: 848-278-9798
  • Fax:
Mailing address:
  • Phone: 848-278-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ORLANDO CALDERIN
Title or Position: OPERATIONS DIRECTOR
Credential: OBM
Phone: 305-497-2434