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NPI Code Detail

MEDICARE: UMBRELLA SPECTRUM LLC

MEDICARE: UMBRELLA SPECTRUM 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
1103K00000XBehavior Analyst

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 : 1831774439
Entity Type Code : Organization
Provider Name (Legal Business Name) : UMBRELLA SPECTRUM LLC
Provider Business Mailing Address
First Line : 11922 FAIRWAY LAKES DR STE 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8384
Country : US
Telephone Number : 239-219-3409
Fax Number : 941-564-5542
Provider Business Practice Location Address
First Line : 11922 FAIRWAY LAKES DR STE 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8384
Country : US
Telephone Number : 239-219-3409
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DANA QORAAN
Credential : BCBA
Telephone Number : 239-219-3409
Provider Enumeration Date : 03/15/2021
Last Update Date : 02/27/2026

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Directions to “UMBRELLA SPECTRUM LLC ” Practice Location

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