MEDICARE: MIND & BEHAVIORAL SOLUTIONS 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

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	:	1740461268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND & BEHAVIORAL SOLUTIONS INC

Provider Business Mailing Address
First Line	:	11996 SW 97TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2623
Country	:	US
Telephone Number	:	305-905-8205
Fax Number	:	305-905-8205

Provider Business Practice Location Address
First Line	:	11996 SW 97TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2623
Country	:	US
Telephone Number	:	305-905-8205
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CYNTHIA CRUZ
Credential	:	LMHC, BCBA
Telephone Number	:	305-905-8205

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	07/14/2023

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