MEDICARE: MARIA A CORONADO BCBA

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	106E00000X	Assistant Behavior Analyst	0-23-14899	FL
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst	1-25-82721	FL

General Provider Information

NPI Number	:	1114547379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA A CORONADO BCBA

Provider Business Mailing Address
First Line	:	9070 KIMBERLY BLVD STE 19-20
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2855
Country	:	US
Telephone Number	:	954-988-0918
Fax Number	:

Provider Business Practice Location Address
First Line	:	5139 MONTECRISTO TER
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-4475
Country	:	US
Telephone Number	:	754-235-3813
Fax Number	:

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

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	07/21/2025

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Directions to “ MARIA A CORONADO BCBA” Practice Location

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