Healthcare Provider Details

I. General information

NPI: 1770294597
Provider Name (Legal Business Name): I & R BEHAVIOR THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 SW 117TH AVE STE C101
MIAMI FL
33186-2184
US

IV. Provider business mailing address

8900 SW 117TH AVE STE C101
MIAMI FL
33186-2184
US

V. Phone/Fax

Practice location:
  • Phone: 786-568-1259
  • Fax:
Mailing address:
  • Phone: 786-568-1259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: IVET REGALADO RODRIGUEZ
Title or Position: OWNER
Credential:
Phone: 786-568-1259