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NPI Code Detail

MEDICARE: PEARSON KLEIN MA, BCBA

MEDICARE: PEARSON KLEIN MA, BCBA
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
1103K00000XBehavior Analyst1-12-10524

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 : 1558616078
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEARSON KLEIN MA, BCBA
Provider Business Mailing Address
First Line : 2912 SW 34TH AVE
Second Line :
City : OCALA
State : FL
Zip : 34474-3364
Country : US
Telephone Number : 956-454-8539
Fax Number : 866-587-2383
Provider Business Practice Location Address
First Line : 2912 SW 34TH AVE
Second Line :
City : OCALA
State : FL
Zip : 34474-3364
Country : US
Telephone Number : 956-454-8539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2012
Last Update Date : 12/16/2024

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