MEDICARE: ONE SOUL CMH INC

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

General Provider Information

NPI Number	:	1164265120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE SOUL CMH INC

Provider Business Mailing Address
First Line	:	5901 NW 183RD ST STE 128
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33015-6009
Country	:	US
Telephone Number	:	786-332-4965
Fax Number	:	786-362-6077

Provider Business Practice Location Address
First Line	:	5901 NW 183RD ST STE 128
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33015-6009
Country	:	US
Telephone Number	:	786-332-4965
Fax Number	:	786-362-6077

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	YULEXIS L NAVARRO
Credential	:
Telephone Number	:	786-332-4965

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	06/17/2024

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Directions to “ONE SOUL CMH INC ” Practice Location

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