MEDICARE: ARIANNA FONSECA MAYOR BCBA-1-26-87703

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	20-110848	FL
2	103K00000X	Behavior Analyst	BCBA-1-26-87703	FL
3	106E00000X	Assistant Behavior Analyst

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	:	1518590751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANNA FONSECA MAYOR BCBA-1-26-87703

Provider Business Mailing Address
First Line	:	3004 36TH ST W
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33971-6746
Country	:	US
Telephone Number	:	239-834-2267
Fax Number	:

Provider Business Practice Location Address
First Line	:	3004 36TH ST W
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33971-6746
Country	:	US
Telephone Number	:	239-834-2267
Fax Number	:

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

Provider Enumeration Date	:	02/17/2020
Last Update Date	:	03/17/2026

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