MEDICARE: BEHAVIORAL PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Q535010904450	OTHER	FL	DL

General Provider Information

NPI Number	:	1073187357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL PARTNERS LLC

Provider Business Mailing Address
First Line	:	2213 NW 2ND AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-4139
Country	:	US
Telephone Number	:	239-710-1815
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 PIERCE ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-3827
Country	:	US
Telephone Number	:	786-803-9360
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTONIO QUINTANA
Credential	:
Telephone Number	:	786-803-9360

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	11/03/2023

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Directions to “BEHAVIORAL PARTNERS LLC ” Practice Location

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