MEDICARE: MARK MOORE BEHAVIOR TECHNICIAN

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

General Provider Information

NPI Number	:	1659101582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK MOORE BEHAVIOR TECHNICIAN

Provider Business Mailing Address
First Line	:	1740 S STATE ROAD 7 APT 104
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4654
Country	:	US
Telephone Number	:	267-393-6978
Fax Number	:

Provider Business Practice Location Address
First Line	:	1740 S STATE ROAD 7 APT 104
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4654
Country	:	US
Telephone Number	:	267-393-6978
Fax Number	:

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

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	09/11/2024

Similar Medicare Providers

1538133970 — JANET L. CAMPBELL LCSW
Practice Location Address:

22 NORTH ST
BLOOMINGBURG, NY
12721-4654

Practice Phone: 845-733-6759
Practice Fax: 845-733-6759

1851444723 — MR. VIINCENT R COLUCCIO LCSW
Practice Location Address:

22 NORTH RD.
BLOOMBURG, NY
12721-4654

Practice Phone: 845-733-5626
Practice Fax:

1427324110 — ROBERT STRYKER
Practice Location Address:

4560 VINSETTA AVE
NORTH FORT MYERS, FL
33903-4654

Practice Phone: 678-371-7189
Practice Fax: 239-747-7177

1003249053 — UNION DENTAL PLLC
Practice Location Address:

4654 HIGHWAY 6 NORTH , SUITE 401
HOUSTON, TX
77084

Practice Phone: 832-683-4034
Practice Fax: 832-680-4782

1376955138 — STRYKER BEHAVIORAL HEALTH, INC
Practice Location Address:

4560 VINSETTA AVE
NORTH FORT MYERS, FL
33903-4654

Practice Phone: 678-371-7189
Practice Fax: 239-747-7177

1083493373 — MS. MICHELLE A QUINONES RDN,LDN
Practice Location Address:

13005 NE 4TH AVE
NORTH MIAMI, FL
33161-4654

Practice Phone: 305-467-3699
Practice Fax:

Directions to “ MARK MOORE BEHAVIOR TECHNICIAN” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.