Provider Demographics
NPI:1063994754
Name:MIAMI BEHAVIORAL MEDICINE CORP
Entity type:Organization
Organization Name:MIAMI BEHAVIORAL MEDICINE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:R
Authorized Official - Last Name:PEREZ-VERDECIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LMHC, BCBA
Authorized Official - Phone:305-917-5414
Mailing Address - Street 1:8370 W FLAGLER ST STE 226
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2040
Mailing Address - Country:US
Mailing Address - Phone:305-917-5414
Mailing Address - Fax:305-220-1864
Practice Address - Street 1:8370 W FLAGLER ST STE 226
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2040
Practice Address - Country:US
Practice Address - Phone:305-917-5414
Practice Address - Fax:305-220-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8713101Y00000X, 103K00000X, 103TC0700X, 103TR0400X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty