MEDICARE: FIRM FOUNDATIONS BEHAVIORAL THERAPY 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

General Provider Information

NPI Number	:	1477365021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRM FOUNDATIONS BEHAVIORAL THERAPY LLC

Provider Business Mailing Address
First Line	:	8912 SW 226TH TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1326
Country	:	US
Telephone Number	:	305-801-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	8912 SW 226TH TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1326
Country	:	US
Telephone Number	:	305-801-3134
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TAYLOR DE TUYA
Credential	:
Telephone Number	:	305-801-3134

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	01/21/2025

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