Healthcare Provider Details

I. General information

NPI: 1174289243
Provider Name (Legal Business Name): SHAPING HORIZONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16739 SW 54TH CT
MIRAMAR FL
33027-4929
US

IV. Provider business mailing address

16739 SW 54TH CT
MIRAMAR FL
33027-4929
US

V. Phone/Fax

Practice location:
  • Phone: 786-859-1363
  • Fax:
Mailing address:
  • Phone: 786-859-1363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENIS CARO
Title or Position: OWNER
Credential: BCBA
Phone: 786-859-1363