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NPI Code Detail

MEDICARE: FERNANDE THERLONGE

MEDICARE: FERNANDE THERLONGE
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 : 1518551860
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDE THERLONGE
Provider Business Mailing Address
First Line : 1552 NW 14TH CIR # 133
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-1986
Country : US
Telephone Number : 954-684-5891
Fax Number :
Provider Business Practice Location Address
First Line : 7601 N FEDERAL HWY STE 150A
Second Line :
City : BOCA RATON
State : FL
Zip : 33487-1663
Country : US
Telephone Number : 754-399-8507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2021
Last Update Date : 11/19/2024

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Directions to “ FERNANDE THERLONGE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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