Healthcare Provider Details

I. General information

NPI: 1881293702
Provider Name (Legal Business Name): ALOMA BEHAVIOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3399 NW 72ND AVE STE 210
MIAMI FL
33122-1343
US

IV. Provider business mailing address

3399 NW 72ND AVE STE 210
MIAMI FL
33122-1343
US

V. Phone/Fax

Practice location:
  • Phone: 786-360-4328
  • Fax:
Mailing address:
  • Phone: 786-360-4328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAYMA ALOMA
Title or Position: PRESIDENT
Credential:
Phone: 786-360-4328