Healthcare Provider Details

I. General information

NPI: 1205100997
Provider Name (Legal Business Name): AL BEHAVIORAL CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3265 VIRGINIA ST SUITE 20
MIAMI FL
33133-5240
US

IV. Provider business mailing address

3265 VIRGINIA ST SUITE 20
MIAMI FL
33133-5240
US

V. Phone/Fax

Practice location:
  • Phone: 305-322-1651
  • Fax: 786-429-0462
Mailing address:
  • Phone: 305-322-1651
  • Fax: 786-429-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1-10-7842
License Number StateFL

VIII. Authorized Official

Name: MR. ALEXANDER LORENZO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.S., BCBA
Phone: 305-322-1651