Healthcare Provider Details
I. General information
NPI: 1174410393
Provider Name (Legal Business Name): JMD BEHAVIOR INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10300 SW 72ND ST STE 457
MIAMI FL
33173-3000
US
IV. Provider business mailing address
10300 SW 72ND ST STE 457
MIAMI FL
33173-3000
US
V. Phone/Fax
- Phone: 305-392-0965
- Fax:
- Phone: 305-392-0965
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARIA
POU
Title or Position: CEO
Credential:
Phone: 786-212-0111