Provider Demographics
NPI:1790933604
Name:NEUROBEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:NEUROBEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-445-9554
Mailing Address - Street 1:PO BOX 142064
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-2064
Mailing Address - Country:US
Mailing Address - Phone:305-445-9554
Mailing Address - Fax:786-235-1074
Practice Address - Street 1:100 MIRACLE MILE
Practice Address - Street 2:SUITE 330
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5430
Practice Address - Country:US
Practice Address - Phone:305-445-9554
Practice Address - Fax:786-235-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 0003733103T00000X
FLPY4487103TC0700X
FLPY 2120103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty