MEDICARE: AUTOMATICITY, 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	251S00000X	Community/Behavioral Health Agency	1-08-4558	FL
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1750603064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUTOMATICITY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 770173
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-0003
Country	:	US
Telephone Number	:	305-846-9807
Fax Number	:

Provider Business Practice Location Address
First Line	:	12485 SW 137TH AVE
Second Line	:	301
City	:	MIAMI
State	:	FL
Zip	:	33186-4216
Country	:	US
Telephone Number	:	305-846-9807
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ADAM VENTURA
Credential	:
Telephone Number	:	305-846-9807

Provider Enumeration Date	:	02/28/2010
Last Update Date	:	06/20/2016

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