| Miracles Behavior Therapy Corp | |
|
9160 Forum Corporate Pkwy Ste 350 Fort Myers FL 33905-7808 | |
| (786) 557-0300 | |
| Not Available |
| Full Name | Miracles Behavior Therapy Corp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 9160 Forum Corporate Pkwy Ste 350, Fort Myers, Florida |
| Authorized Official Name and Position | Marlon Medina (CEO) |
| Authorized Official Contact | 7862507352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracles Behavior Therapy Corp 9160 Forum Corporate Pkwy Ste 350 Fort Myers FL 33905-7808 Ph: (786) 557-0300 | Miracles Behavior Therapy Corp 9160 Forum Corporate Pkwy Ste 350 Fort Myers FL 33905-7808 Ph: (786) 557-0300 |
| NPI Number | 1639814627 |
|---|---|
| Provider Enumeration Date | 05/03/2022 |
| Last Update Date | 05/03/2022 |
| Certification Date | 05/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639814627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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