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General NPI Number Information
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NPI Number | 1518457126
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Entity Type | Organization
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Legal Business Name | FLORIDA BEHAVIORAL CARE LLC
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 21376 MARINA COVE CIR APT 18C
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City | AVENTURA
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State | FL
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Zip | 33180-3561
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Country | US
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Telephone | 786-853-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 8333 W MCNAB RD STE 131
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City | TAMARAC
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State | FL
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Zip | 33321-3203
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Country | US
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Telephone | 786-490-7788
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Fax | 786-219-3883
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Authorized Official
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Title or Position | MANAGER
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Name | YULIA NOSIKOVSKY
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Credential |
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Telephone | 786-490-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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