Organization
AUTISM SPECIALTY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL RONACHER (CFO)
(786) 553-6663
Entity
Organization
Contact information
Practice address
144 NW 37TH ST, MIAMI, FL 33127-3111
(305) 767-1924
(305) 673-5917
Mailing address
PO BOX 12618, MIAMI, FL 33101-2618
(305) 767-1924
(305) 673-5917
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016704400
—
FL
Enumeration date
06/02/2022
Last updated
06/27/2022
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