MEDICARE: AYE COUNSELOR & BEHAVIOR THERAPY 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1306300538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AYE COUNSELOR & BEHAVIOR THERAPY INC

Provider Business Mailing Address
First Line	:	8100 NW 155TH ST STE 200
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5865
Country	:	US
Telephone Number	:	786-241-1761
Fax Number	:	786-542-5084

Provider Business Practice Location Address
First Line	:	8100 NW 155TH ST STE 200
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5865
Country	:	US
Telephone Number	:	786-241-1761
Fax Number	:	786-542-5084

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YAMILE MUNOZ PANG
Credential	:
Telephone Number	:	786-241-1761

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	07/25/2023

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