Provider Demographics
NPI:1801401500
Name:PARADIGM KIDS MIAMI LLC
Entity Type:Organization
Organization Name:PARADIGM KIDS MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALGENYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-402-4101
Mailing Address - Street 1:11455 SW 40TH ST # 271
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3311
Mailing Address - Country:US
Mailing Address - Phone:305-402-4101
Mailing Address - Fax:305-902-2536
Practice Address - Street 1:11375 SW 45TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165
Practice Address - Country:US
Practice Address - Phone:305-402-4101
Practice Address - Fax:305-902-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty