MEDICARE: IC 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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1598463267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IC BEHAVIOR SERVICES INC

Provider Business Mailing Address
First Line	:	15315 NW 60TH AVE STE D
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2440
Country	:	US
Telephone Number	:	305-978-2972
Fax Number	:

Provider Business Practice Location Address
First Line	:	15315 NW 60TH AVE STE D
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2440
Country	:	US
Telephone Number	:	305-978-2972
Fax Number	:

Authorized Official
Title or Position	:	OWNER/APRN
Name	:	ILIANA CAMEJO
Credential	:	OWNER/APRN
Telephone Number	:	305-978-2972

Provider Enumeration Date	:	02/21/2023
Last Update Date	:	04/03/2025

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Directions to “IC BEHAVIOR SERVICES INC ” Practice Location

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