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General NPI Number Information
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NPI Number | 1558685768
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Entity Type | Individual
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Provider Name | ADAM VENTURA MS BCBA
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Gender | Male
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 13991 SW 122ND AVE APT 307
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City | MIAMI
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State | FL
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Zip | 33186-6256
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Country | US
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Telephone | 305-775-6005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 770173
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City | MIAMI
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State | FL
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Zip | 33177-0003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1084558
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License Number State | FL
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