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NPI Code Detail

MEDICARE: NICOLE GARRETT

MEDICARE: NICOLE GARRETT
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 TechnicianRBT-20-109830

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093355539
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE GARRETT
Provider Business Mailing Address
First Line : 1202 TECH BLVD STE 103
Second Line :
City : TAMPA
State : FL
Zip : 33619-7863
Country : US
Telephone Number : 813-842-1656
Fax Number :
Provider Business Practice Location Address
First Line : 1202 TECH BLVD STE 103
Second Line :
City : TAMPA
State : FL
Zip : 33619-7863
Country : US
Telephone Number : 813-438-6796
Fax Number : 813-252-1367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2020
Last Update Date : 11/27/2023

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Directions to “ NICOLE GARRETT ” Practice Location

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