Provider Demographics
NPI:1992412217
Name:BUTTERFLY GARDEN ABA THERAPY CORP
Entity type:Organization
Organization Name:BUTTERFLY GARDEN ABA THERAPY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YANELIET
Authorized Official - Middle Name:
Authorized Official - Last Name:MUJICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-776-4409
Mailing Address - Street 1:3101 SW 142ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6620
Mailing Address - Country:US
Mailing Address - Phone:305-776-4409
Mailing Address - Fax:
Practice Address - Street 1:2200 N COMMERCE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3258
Practice Address - Country:US
Practice Address - Phone:305-776-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health