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NPI Code Detail

MEDICARE: CHRISTAL JOY HUIZAR

MEDICARE: CHRISTAL JOY HUIZAR
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

General Provider Information

NPI Number : 1477104768
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTAL JOY HUIZAR
Provider Business Mailing Address
First Line : 19098 FLAMINGO RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33967-3617
Country : US
Telephone Number : 917-324-7919
Fax Number :
Provider Business Practice Location Address
First Line : 11922 FAIRWAY LAKES DR STE 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8384
Country : US
Telephone Number : 392-193-4092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2019
Last Update Date : 02/27/2024

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Directions to “ CHRISTAL JOY HUIZAR ” Practice Location

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