MEDICARE: MARIA FERNANDA GUZMAN CAZANOLA

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	106S00000X	Behavior Technician	RBT-24-364375	FL

General Provider Information

NPI Number	:	1043048382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA FERNANDA GUZMAN CAZANOLA

Provider Business Mailing Address
First Line	:	2791 S FLORIDA MANGO RD APT 114
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-2213
Country	:	US
Telephone Number	:	305-924-6978
Fax Number	:

Provider Business Practice Location Address
First Line	:	2791 S FLORIDA MANGO RD APT 114
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-2213
Country	:	US
Telephone Number	:	305-924-6978
Fax Number	:

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

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	08/21/2024

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Directions to “ MARIA FERNANDA GUZMAN CAZANOLA ” Practice Location

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