Provider Demographics
NPI:1760839898
Name:FLORIDA FAMILY SUPPORT LLC
Entity type:Organization
Organization Name:FLORIDA FAMILY SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-305-6367
Mailing Address - Street 1:5300 W HILLSBORO BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4397
Mailing Address - Country:US
Mailing Address - Phone:305-305-6367
Mailing Address - Fax:561-423-3105
Practice Address - Street 1:5300 W HILLSBORO BLVD STE 208
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4397
Practice Address - Country:US
Practice Address - Phone:305-305-6367
Practice Address - Fax:561-423-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLMH14122261QM0855X
FL11415726261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health