Healthcare Provider Details

I. General information

NPI: 1710696059
Provider Name (Legal Business Name): NORTH ACADEMY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

659 NE 125TH ST
NORTH MIAMI FL
33161-5503
US

IV. Provider business mailing address

659 NE 125TH ST
NORTH MIAMI FL
33161-5503
US

V. Phone/Fax

Practice location:
  • Phone: 305-454-9885
  • Fax: 305-402-2203
Mailing address:
  • Phone: 305-454-9885
  • 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: ADRIAN DIAZ
Title or Position: OWNER
Credential:
Phone: 305-454-9885