Healthcare Provider Details

I. General information

NPI: 1386189512
Provider Name (Legal Business Name): JORGE HANS ABREU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2016
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12880 SW 62ND LN
MIAMI FL
33183-5442
US

IV. Provider business mailing address

12880 SW 62ND LN
MIAMI FL
33183-5442
US

V. Phone/Fax

Practice location:
  • Phone: 786-520-9822
  • Fax:
Mailing address:
  • Phone: 786-520-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90099
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-58174
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: