Healthcare Provider Details

I. General information

NPI: 1205578101
Provider Name (Legal Business Name): ADVANCED RECOVERY & COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7241 SW 63RD AVE STE 101A
SOUTH MIAMI FL
33143-4838
US

IV. Provider business mailing address

14400 NW 77TH CT STE 100
MIAMI LAKES FL
33016-1590
US

V. Phone/Fax

Practice location:
  • Phone: 786-916-6073
  • Fax: 786-657-3092
Mailing address:
  • Phone: 786-916-6073
  • Fax: 786-657-3092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LUIS BERNARDO BOTERO
Title or Position: HEAD OF BUSINESS
Credential: MBA
Phone: 786-916-6073