Healthcare Provider Details

I. General information

NPI: 1659233187
Provider Name (Legal Business Name): REAL ACADEMY BEHAVIOR THERAPY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 S STATE ROAD 7 STE 364
MIRAMAR FL
33023-7203
US

IV. Provider business mailing address

3600 S STATE ROAD 7 STE 364
MIRAMAR FL
33023-7203
US

V. Phone/Fax

Practice location:
  • Phone: 786-508-8258
  • Fax:
Mailing address:
  • Phone: 786-508-8258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SAIRA V MENDOZA
Title or Position: PRESIDENT
Credential:
Phone: 786-508-8258