Healthcare Provider Details

I. General information

NPI: 1780122218
Provider Name (Legal Business Name): BEHAVIORAL CENTERS OF SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 N FLAMINGO RD STE 280
PEMBROKE PINES FL
33028-1031
US

IV. Provider business mailing address

1806 N FLAMINGO RD STE 280
PEMBROKE PINES FL
33028-1031
US

V. Phone/Fax

Practice location:
  • Phone: 954-866-1202
  • Fax: 954-507-9655
Mailing address:
  • Phone: 954-866-1202
  • Fax: 954-507-9655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS YIPSI MARTIN
Title or Position: MGR
Credential:
Phone: 954-866-1202