Gladys Maria Fundora, LMHC, BCBA is a medicare enrolled "Behavior Analyst" provider in Miami, Florida. Her current practice location is
12917 Sw 133rd Ter, Miami, Florida. You can reach out to her office (for appointments etc.) via phone at
(305) 731-4067.
Gladys Maria Fundora is licensed to practice in * (Not Available) (license number BCBA19-38877) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699029934.
Healthcare Provider's Profile
| Full Name | Gladys Maria Fundora |
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| Gender | Female |
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| Speciality | Behavior Analyst |
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| Location | 12917 Sw 133rd Ter, Miami, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699029934
- Provider Enumeration Date: 11/08/2012
- Last Update Date: 08/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 9931540861
- Enrollment ID: I20240509002425
Medical Identifiers
Medical identifiers for Gladys Maria Fundora such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699029934 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | MH14818 (Florida) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | BCBA19-38877 (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gladys Maria Fundora allows following entities to bill medicare on her behalf.
| Entity Name | Perfect Wellness Center, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1649895145
PECOS PAC ID: 9335569391
Enrollment ID: O20201014000470 |
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| Entity Name | Renaissance Mental Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407439383
PECOS PAC ID: 6305233404
Enrollment ID: O20220419003034 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gladys Maria Fundora is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Gladys Maria Fundora, LMHC, BCBA
12917 Sw 133rd Ter,
Miami, FL 33186-6906
Ph: (305) 731-4067 | Gladys Maria Fundora, LMHC, BCBA
12917 Sw 133rd Ter,
Miami, FL 33186-6906
Ph: (305) 731-4067 |
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