Provider Demographics
NPI:1952941965
Name:SOUTH FLORIDA BEHAVIORAL GROUP LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA BEHAVIORAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-380-7211
Mailing Address - Street 1:8050 NW 8TH ST APT 211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4038
Mailing Address - Country:US
Mailing Address - Phone:786-380-7211
Mailing Address - Fax:
Practice Address - Street 1:3175 S CONGRESS AVE # C301-CD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2500
Practice Address - Country:US
Practice Address - Phone:786-380-7211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management