Provider Demographics
NPI:1457396574
Name:BIO-BEHAVIORAL CORP.
Entity Type:Organization
Organization Name:BIO-BEHAVIORAL CORP.
Other - Org Name:GO 2 HELP NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LMHC, BEHAVIOR ANALYST, CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:GUSTAVO
Authorized Official - Last Name:JEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, QS
Authorized Official - Phone:786-601-2608
Mailing Address - Street 1:PO BOX 700731
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-0731
Mailing Address - Country:US
Mailing Address - Phone:786-601-2608
Mailing Address - Fax:305-647-0250
Practice Address - Street 1:11855 SW 216TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-2945
Practice Address - Country:US
Practice Address - Phone:786-601-2608
Practice Address - Fax:305-647-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5950101YM0800X
103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020425300Medicaid