Organization
BEHAVERUS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILDRED MILAGROS FERNANDEZ FL-CBA (PRESIDENT)
(407) 579-2507
Entity
Organization
Contact information
Practice address
9542 BRACKIN ST, ORLANDO, FL 32825-6124
(407) 579-2507
Mailing address
9542 BRACKIN ST, ORLANDO, FL 32825-6124
(407) 579-2507
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
0215
FL
Other
Enumeration date
11/07/2009
Last updated
01/23/2018
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