MEDICARE: L & L BEHAVIOR CONSULTING, 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	251S00000X	Community/Behavioral Health Agency	0041424	FL

General Provider Information

NPI Number	:	1144649781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L & L BEHAVIOR CONSULTING, LLC

Provider Business Mailing Address
First Line	:	981 NW 132ND AVE W
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33182-2313
Country	:	US
Telephone Number	:	305-227-7082
Fax Number	:

Provider Business Practice Location Address
First Line	:	981 NW 132ND AVE W
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33182-2313
Country	:	US
Telephone Number	:	305-227-7082
Fax Number	:

Authorized Official
Title or Position	:	BCABA
Name	:	MR. LEONARDO ALBERTO INCLAN
Credential	:	PRESIDENT
Telephone Number	:	305-227-7082

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	04/10/2014

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