Incredible Mind Behavior Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

INCREDIBLE MIND BEHAVIOR SERVICES LLC

Practice address

175 Fontainebleau Blvd # 1K2
Miami, FL 33172-7018

Phone

(786) 763-1109

NPI assigned

Nov 29, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Joaquin Camejo

Title

Authorized Offical

Phone

(305) 967-3918

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1912617002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FONTAINEBLEAU BLVD # 1K2",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727018",
            "telephone_number": "786-763-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FONTAINEBLEAU BLVD # 1K2",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727018",
            "telephone_number": "786-763-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCREDIBLE MIND BEHAVIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "CAMEJO",
        "authorized_official_first_name": "JOAQUIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "305-967-3918",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "764495",
            "identifier": "LBT",
            "state": "FL"
        }
    ],
    "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 Nov 29, 2022; 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.