=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952193955
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVERLASTING THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2025
-----------------------------------------------------
Last Update Date | 05/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2480 NW 55TH TER
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33142-2924
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-824-2596
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2480 NW 55TH TER
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33142-2924
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-824-2596
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. KAREN IDALIA ZITOUNI
-----------------------------------------------------
Credential | MA, BCBA
-----------------------------------------------------
Telephone | 786-824-2596
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------