MEDICARE: DREAMS COME TRUE BT 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	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1861104242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAMS COME TRUE BT LLC

Provider Business Mailing Address
First Line	:	13411 SW 110TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4352
Country	:	US
Telephone Number	:	786-294-8753
Fax Number	:

Provider Business Practice Location Address
First Line	:	13411 SW 110TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4352
Country	:	US
Telephone Number	:	786-294-8753
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	GABRIEL CASANAS
Credential	:
Telephone Number	:	786-294-8753

Provider Enumeration Date	:	12/19/2022
Last Update Date	:	12/22/2022

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Directions to “DREAMS COME TRUE BT LLC ” Practice Location

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