Provider Demographics
NPI:1154039766
Name:MIAMI BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:MIAMI BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-308-9375
Mailing Address - Street 1:15592 SW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2837
Mailing Address - Country:US
Mailing Address - Phone:786-308-9375
Mailing Address - Fax:
Practice Address - Street 1:13701 SW 88TH ST STE 307
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1309
Practice Address - Country:US
Practice Address - Phone:786-308-9375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty