Healthcare Provider Details
I. General information
NPI: 1124922638
Provider Name (Legal Business Name): WEST KENDALL BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5927 SW 152ND CT
MIAMI FL
33193-2549
US
IV. Provider business mailing address
5927 SW 152ND CT
MIAMI FL
33193-2549
US
V. Phone/Fax
- Phone: 786-412-3969
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
DAHILIN
GONZALEZ FERRAZ
Title or Position: CEO
Credential:
Phone: 786-412-3969