MEDICARE: CELINE DENISE NG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-26-89407	FL

General Provider Information

NPI Number	:	1013519560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE DENISE NG

Provider Business Mailing Address
First Line	:	3000 47TH ST W
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33971-5862
Country	:	US
Telephone Number	:	786-606-1109
Fax Number	:	786-606-1109

Provider Business Practice Location Address
First Line	:	12734 KENWOOD LN
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5666
Country	:	US
Telephone Number	:	407-309-9174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	05/04/2026

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Directions to “ CELINE DENISE NG ” Practice Location

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