Provider Demographics
NPI:1992515100
Name:MAYORAL BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:MAYORAL BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ODELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYORAL MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIOR ANALYST
Authorized Official - Phone:786-250-3223
Mailing Address - Street 1:13200 SW 128TH ST STE E2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5831
Mailing Address - Country:US
Mailing Address - Phone:786-250-3223
Mailing Address - Fax:
Practice Address - Street 1:13200 SW 128TH ST STE E2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5831
Practice Address - Country:US
Practice Address - Phone:786-250-3223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty