Organization
AVANTI BEHAVIORAL CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIRVANA MATTEY MS, CPC, ITDS (PRESIDENT)
(305) 607-4116
Entity
Organization
Contact information
Practice address
9595 FONTAINEBLEAU BLVD, APT 2002, MIAMI, FL 33172-6883
(305) 607-4116
(305) 503-7088
Mailing address
9595 FONTAINEBLEAU BLVD, APT 2002, MIAMI, FL 33172-6883
(305) 607-4116
(305) 503-7088
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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