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General NPI Number Information
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NPI Number | 1285227678
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Entity Type | Organization
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Legal Business Name | BG EMPIRE INVESTMENT & ACQUISITIONS CORP
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 17971 BISCAYNE BLVD STE 110
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City | AVENTURA
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State | FL
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Zip | 33160-2531
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Country | US
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Telephone | 305-749-3682
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Fax |
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Provider Business Mailing Address
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Address Line | 401 E LAS OLAS BLVD # 130-439
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2210
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Country | US
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Telephone | 305-749-3682
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AYO K TILLMAN
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Credential |
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Telephone | 954-292-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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