Healthcare Provider Details

I. General information

NPI: 1699297036
Provider Name (Legal Business Name): NATASHA BEENE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 03/04/2024
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BRICKELL T DRIVE SUITE 700
MIAMI FL
33131
US

IV. Provider business mailing address

777 BRICKELL AVE STE 500
MIAMI FL
33131-2803
US

V. Phone/Fax

Practice location:
  • Phone: 800-944-0217
  • Fax: 800-991-2996
Mailing address:
  • Phone: 703-869-1433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-30717
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: