MEDICARE: D&M BEHAVIOR 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1770090615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&M BEHAVIOR THERAPY, LLC

Provider Business Mailing Address
First Line	:	20126 NW 52ND CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-4630
Country	:	US
Telephone Number	:	786-222-0825
Fax Number	:

Provider Business Practice Location Address
First Line	:	20126 NW 52ND CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-4630
Country	:	US
Telephone Number	:	786-222-0825
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIANELA GAFAROT
Credential	:
Telephone Number	:	786-222-0825

Provider Enumeration Date	:	12/31/2017
Last Update Date	:	12/31/2017

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Directions to “D&M BEHAVIOR THERAPY, LLC ” Practice Location

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