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1457396574 NPI number — BIO-BEHAVIORAL CORP.

NPI Number: 1457396574
Health Care Provider/Practitioner: BIO-BEHAVIORAL CORP.

Information about “1457396574” NPI (BIO-BEHAVIORAL CORP.) exists in 1457396574 in HTML format HTML  |  1457396574 in plain Text format TXT  |  1457396574 in PDF (Portable Document Format) PDF  |  1457396574 in an XML format XML  formats.

NPI Number : 1457396574 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457396574",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BIO-BEHAVIORAL CORP.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 700731",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIAMI",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33170-0731",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-601-2608",
    "MailingAddressFaxNumber": "305-647-0250",
    "FirstLinePracticeLocationAddress": "11855 SW 216TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIAMI",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33170-2945",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-601-2608",
    "PracticeLocationAddressFaxNumber": "305-647-0250",
    "EnumerationDate": "06/20/2006",
    "LastUpdateDate": "07/05/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JEREZ",
    "AuthorizedOfficialFirstName": "SAMIR",
    "AuthorizedOfficialMiddleName": "GUSTAVO",
    "AuthorizedOfficialTitle": "LMHC, BEHAVIOR ANALYST, CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MA, LMHC, QS",
    "AuthorizedOfficialTelephoneNumber": "786-601-2608",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "MH 5950",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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