=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245106541
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TWO STEPS FORWARD THERAPY SERVICE CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2025
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13255 SW 137TH AVE STE 212
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33186-5328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-964-5685
-----------------------------------------------------
Fax | 386-433-2003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13255 SW 137TH AVE STE 212
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33186-5328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-964-5685
-----------------------------------------------------
Fax | 386-433-2003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. JACQUELINE PEREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-927-1143
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------