Shanadu LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SHANADU LLC

Practice address

9035 SW 72ND St Ste 102
Miami, FL 33173-3441

Phone

(305) 790-9504

NPI assigned

Nov 28, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samlis Samuell BouzaNPI 1639422041

Title

Owner

Phone

(305) 790-9504

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samlis Samuell Bouza

  • Behavior Analyst
  • Miami, FL
  • NPI 1639422041
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1548970932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9035 SW 72ND ST STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733441",
            "telephone_number": "305-790-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 SW 72ND ST STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733441",
            "telephone_number": "305-790-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANADU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "SAMUELL BOUZA",
        "authorized_official_first_name": "SAMLIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-790-9504"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Miami, FL
• Providers in Miami, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.