MEDICARE: SPRING HEALTH AUTISM INTERVENTION LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1518784131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING HEALTH AUTISM INTERVENTION LLC

Provider Business Mailing Address
First Line	:	3080 TAMIAMI TRL E UNIT 301
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-5777
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3080 TAMIAMI TRL E UNIT 301
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-5777
Country	:	US
Telephone Number	:	561-831-9021
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YOLANDA DELGADO BAEZ
Credential	:
Telephone Number	:	561-831-9021

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	09/24/2024

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