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NPI Code Detail

MEDICARE: KASSANDRA BACHAN

MEDICARE: KASSANDRA BACHAN
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
2103K00000XBehavior Analyst1-24-72102FL

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 : 1518578269
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASSANDRA BACHAN
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-244-1818
Fax Number :
Provider Business Practice Location Address
First Line : 2000 N ALAFAYA TRL STE 300
Second Line :
City : ORLANDO
State : FL
Zip : 32826-4741
Country : US
Telephone Number : 407-974-6557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2020
Last Update Date : 04/16/2024

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Directions to “ KASSANDRA BACHAN ” Practice Location

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