| Raise Group Inc | |
|
8500 Sw 8th St Ste 258 Miami FL 33144-4000 | |
| (305) 810-8869 | |
| (305) 402-6468 |
| Full Name | Raise Group Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8500 Sw 8th St Ste 258, Miami, Florida |
| Authorized Official Name and Position | Nancy Mirabal (P) |
| Authorized Official Contact | 3052822144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raise Group Inc 8500 Sw 8th St Ste 258 Miami FL 33144-4000 Ph: (305) 810-8869 | Raise Group Inc 8500 Sw 8th St Ste 258 Miami FL 33144-4000 Ph: (305) 810-8869 |
| NPI Number | 1932800646 |
|---|---|
| Provider Enumeration Date | 03/10/2023 |
| Last Update Date | 04/29/2024 |
| Certification Date | 04/29/2024 |
| Medicare PECOS PAC ID | 9931550563 |
|---|---|
| Medicare Enrollment ID | O20240109000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932800646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Leonardo Lorenzo Chacon Asusta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730695933 PECOS PAC ID: 9830583939 Enrollment ID: I20220307002495 |
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