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Organization
PROFESSIONAL BEHAVIOR CARE LLC
Active
Organization
PROFESSIONAL BEHAVIOR CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO ROQUE (MBR)
(786) 600-9378
Entity
Organization
Contact information
Practice address
6447 MIAMI LAKES DR E STE 103C, MIAMI LAKES, FL 33014-2771
(786) 600-9378
Mailing address
6447 MIAMI LAKES DR E STE 103C, MIAMI LAKES, FL 33014-2771
(786) 600-9378
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
01/29/2018
Last updated
01/29/2018
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