Healthcare Provider Details

I. General information

NPI: 1154039766
Provider Name (Legal Business Name): MIAMI BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST STE 467
MIAMI FL
33173-3028
US

IV. Provider business mailing address

15592 SW 63RD TER
MIAMI FL
33193-2837
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-7213
  • Fax: 786-528-3059
Mailing address:
  • Phone: 786-308-9375
  • 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 Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: KEVIN ALEXANDER BUI
Title or Position: OWNER
Credential:
Phone: 786-316-6929