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NPI Code Detail

MEDICARE: VERONICA O'CONNOR

MEDICARE:   VERONICA  O'CONNOR
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1073056032
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA O'CONNOR
Provider Business Mailing Address
First Line : 175 MIDDLE ST
Second Line : SUITE 1201
City : LAKE MARY
State : FL
Zip : 32746-3625
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1128 BEVILLE RD
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-5747
Country : US
Telephone Number : 386-267-3161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2016
Last Update Date : 11/23/2016

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Directions to “ VERONICA O'CONNOR ” Practice Location

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