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General NPI Number Information
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NPI Number | 1730991431
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Entity Type | Organization
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Legal Business Name | CHILDREN BEHAVIORAL HAPPY WORLD LLC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 2141 SW 1ST ST
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City | MIAMI
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State | FL
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Zip | 33135-1694
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Country | US
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Telephone | 786-515-4935
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Fax | 786-409-4027
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Provider Business Mailing Address
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Address Line | 5440 W 21ST CT APT 302
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City | HIALEAH
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State | FL
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Zip | 33016-2061
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Country | US
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Telephone | 786-515-4935
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAITE GARCIA REVES
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Credential |
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Telephone | 786-515-4935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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