Provider Demographics
NPI:1982327169
Name:BULNES BEHAVIOR ANALYSIS SERVICES CORP
Entity Type:Organization
Organization Name:BULNES BEHAVIOR ANALYSIS SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BULNES GUEVARA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-354-6813
Mailing Address - Street 1:1901 HARRISON ST STE 208
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-5180
Mailing Address - Country:US
Mailing Address - Phone:305-354-6813
Mailing Address - Fax:
Practice Address - Street 1:1901 HARRISON ST STE 208
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-5180
Practice Address - Country:US
Practice Address - Phone:305-354-6813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020832800Medicaid