MEDICARE: SHELBIE LAKATOS

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	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-24-75746	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1346780426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBIE LAKATOS

Provider Business Mailing Address
First Line	:	745 ORIENTA AVE STE 1011
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5675
Country	:	US
Telephone Number	:	877-823-4283
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 NW 155TH ST STE 202
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5865
Country	:	US
Telephone Number	:	561-764-7093
Fax Number	:

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

Provider Enumeration Date	:	03/08/2017
Last Update Date	:	10/16/2024

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Directions to “ SHELBIE LAKATOS ” Practice Location

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