Provider Demographics
NPI:1831526151
Name:BRAIN & BEHAVIORAL INSTITUTE OF SOUTH FLORIDA INC
Entity type:Organization
Organization Name:BRAIN & BEHAVIORAL INSTITUTE OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAMS
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:LUCENA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-866-5914
Mailing Address - Street 1:1801 CORAL WAY
Mailing Address - Street 2:SUITE# 327
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2790
Mailing Address - Country:US
Mailing Address - Phone:786-866-5914
Mailing Address - Fax:786-866-5928
Practice Address - Street 1:1801 CORAL WAY
Practice Address - Street 2:SUITE#327
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2790
Practice Address - Country:US
Practice Address - Phone:786-866-5914
Practice Address - Fax:786-866-5928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X, 103K00000X, 261QM0801X
FLMH 8062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty