Healthcare Provider Details

I. General information

NPI: 1982179578
Provider Name (Legal Business Name): IBIS PAIFER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13370 SW 131ST ST STE 104
MIAMI FL
33186-5856
US

IV. Provider business mailing address

13246 SW 86TH ST
MIAMI FL
33183-4161
US

V. Phone/Fax

Practice location:
  • Phone: 786-581-9644
  • Fax: 305-290-5902
Mailing address:
  • Phone: 786-930-5840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-38783
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCM100340
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: