MEDICARE: KIDS LIFE BEHAVIOR SERVICES 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	:	1346998200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDS LIFE BEHAVIOR SERVICES INC.

Provider Business Mailing Address
First Line	:	17911 SW 152ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-7770
Country	:	US
Telephone Number	:	786-637-5168
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 NW 7TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-2303
Country	:	US
Telephone Number	:	786-637-5168
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEYDA URBIZO
Credential	:
Telephone Number	:	786-637-5168

Provider Enumeration Date	:	03/10/2022
Last Update Date	:	03/03/2026

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