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NPI Code Detail

MEDICARE: MRS. YILIANA PUERTO BCBA

MEDICARE: MRS. YILIANA PUERTO 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
1103K00000XBehavior Analyst1-12-12659FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-12-12659OTHERFLBEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number : 1174820286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YILIANA PUERTO BCBA
Provider Business Mailing Address
First Line : 4620 N STATE ROAD 7 STE 300
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5867
Country : US
Telephone Number : 877-535-7888
Fax Number : 561-990-1334
Provider Business Practice Location Address
First Line : 4620 N STATE ROAD 7 STE 300
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5867
Country : US
Telephone Number : 877-535-7888
Fax Number : 561-990-1334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2011
Last Update Date : 04/18/2023

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Directions to “ MRS. YILIANA PUERTO BCBA” Practice Location

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