Provider Demographics
NPI:1760120596
Name:SMART BEHAVIORAL INNOVATION CORP
Entity Type:Organization
Organization Name:SMART BEHAVIORAL INNOVATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-299-8005
Mailing Address - Street 1:121 S 61ST TER STE C
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-1377
Mailing Address - Country:US
Mailing Address - Phone:305-299-8005
Mailing Address - Fax:
Practice Address - Street 1:121 S 61ST TER STE C
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-1377
Practice Address - Country:US
Practice Address - Phone:305-299-8005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty