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NPI Code Detail

MEDICARE: DANIELA MAYORGA

MEDICARE: DANIELA MAYORGA
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

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 : 1265189195
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA MAYORGA
Provider Business Mailing Address
First Line : 12955 MOSS PARK RIDGE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32832-7090
Country : US
Telephone Number : 407-485-8722
Fax Number :
Provider Business Practice Location Address
First Line : 730 SAND LAKE RD STE 176
Second Line :
City : ORLANDO
State : FL
Zip : 32809-7747
Country : US
Telephone Number : 407-368-9627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2022
Last Update Date : 08/24/2022

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Directions to “ DANIELA MAYORGA ” Practice Location

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