| Autism Specialty Group | |
|
144 Nw 37th St Miami FL 33127-3111 | |
| (305) 767-1924 | |
| (305) 673-5917 |
| Full Name | Autism Specialty Group |
|---|---|
| Speciality | Behavior Analyst |
| Location | 144 Nw 37th St, Miami, Florida |
| Authorized Official Name and Position | Raquel Ronacher (CFO) |
| Authorized Official Contact | 7865536663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Specialty Group Po Box 12618 Miami FL 33101-2618 Ph: (305) 767-1924 | Autism Specialty Group 144 Nw 37th St Miami FL 33127-3111 Ph: (305) 767-1924 |
| NPI Number | 1023376217 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 05/23/2022 |
| Certification Date | 05/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023376217 | NPI | - | NPPES |
| 017552000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-10-7874 (Florida) | Primary |
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