MEDICARE: JOVAN Z. PHILLIPS 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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417727264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOVAN Z. PHILLIPS LLC

Provider Business Mailing Address
First Line	:	333 W 41ST ST STE 414
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3608
Country	:	US
Telephone Number	:	786-673-9355
Fax Number	:	954-342-6481

Provider Business Practice Location Address
First Line	:	7062B LAKEVIEW HAVEN DR STE 130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2691
Country	:	US
Telephone Number	:	346-946-5563
Fax Number	:	954-342-6481

Authorized Official
Title or Position	:	OWNER
Name	:	JOVAN PHILLIPS
Credential	:	M.S., BCBA LBA-TX
Telephone Number	:	281-815-5782

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	02/23/2026

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