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Organization
AUTISM SPECIALTY GROUP LLC
Active
Organization
AUTISM SPECIALTY GROUP LLC
Active
Other names
Autism Specialty Group
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL RONACHER (CFO)
(786) 553-6663
Entity
Organization
Contact information
Practice address
64 NW 54TH ST STE 103, MIAMI, FL 33127-1752
(305) 767-1924
Mailing address
64 NW 54TH ST STE 103, MIAMI, FL 33127-1752
(305) 767-1924
(305) 673-5917
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017552000
—
FL
Enumeration date
04/25/2012
Last updated
09/17/2026
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