Organization
E & P BEHAVIOR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTO RODRIGUEZ TANQUERO (PRESIDENT)
(786) 227-2966
Entity
Organization
Contact information
Practice address
12039 SW 132ND CT UNIT 4-5, MIAMI, FL 33186-4783
(786) 227-2966
Mailing address
12039 SW 132ND CT UNIT 4-5, MIAMI, FL 33186-4783
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107602700
—
FL
Enumeration date
08/09/2020
Last updated
10/14/2021
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