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General NPI Number Information
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NPI Number | 1558131672
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Entity Type | Organization
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Legal Business Name | SPECIALTY BEHAVIOR THERAPY INC
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 4471 NW 36TH ST STE 210
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-7288
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Country | US
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Telephone | 305-726-5198
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Fax |
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Provider Business Mailing Address
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Address Line | 4471 NW 36TH ST STE 210
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-7288
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Country | US
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Telephone | 305-726-5198
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARLOS GUITERREZ
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Credential |
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Telephone | 305-726-5198
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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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