Provider Demographics
NPI:1225562788
Name:FLORIDA BEHAVIOR HEALTH GROUP LLC
Entity Type:Organization
Organization Name:FLORIDA BEHAVIOR HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JORDANSKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:BHCM
Authorized Official - Phone:786-399-8182
Mailing Address - Street 1:11980 SW 144TH CT STE 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8626
Mailing Address - Country:US
Mailing Address - Phone:305-640-8918
Mailing Address - Fax:786-391-4465
Practice Address - Street 1:11980 SW 144TH CT STE 210
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8626
Practice Address - Country:US
Practice Address - Phone:305-640-8918
Practice Address - Fax:786-391-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty