Healthcare Provider Details

I. General information

NPI: 1891512463
Provider Name (Legal Business Name): WELLBEHAVED.CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 HARBOUR SIDE DR
WESTON FL
33326-2768
US

IV. Provider business mailing address

1581 HARBOUR SIDE DR
WESTON FL
33326-2768
US

V. Phone/Fax

Practice location:
  • Phone: 954-410-4106
  • Fax:
Mailing address:
  • Phone: 954-410-4106
  • 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 Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LUZ MIRYAM ALEXANDRA TORRENTE
Title or Position: PRESIDENT
Credential: BCBA
Phone: 954-410-4106