MEDICARE: H & Y 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1427665520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H & Y BEHAVIOR THERAPY INC

Provider Business Mailing Address
First Line	:	18844 SW 319TH ST
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-5330
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17901 OLD CUTLER RD STE B305
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-6424
Country	:	US
Telephone Number	:	786-641-1962
Fax Number	:	305-564-6904

Authorized Official
Title or Position	:	OWNER
Name	:	YAIMA PEREZ LUGO
Credential	:
Telephone Number	:	786-641-1962

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	12/05/2023

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