Healthcare Provider Details

I. General information

NPI: 1417630013
Provider Name (Legal Business Name): MEKA BEHAVIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21210 SW 127TH PL
MIAMI FL
33177-5556
US

IV. Provider business mailing address

21210 SW 127TH PL
MIAMI FL
33177-5556
US

V. Phone/Fax

Practice location:
  • Phone: 305-331-0378
  • Fax:
Mailing address:
  • Phone: 305-331-0378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. JORGE FELIX HERNANDEZ PUPO
Title or Position: PRESIDENT
Credential: PRESIDENT
Phone: 305-331-0378