MEDICARE: HAYLEY MARIE BIERSACK 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
1	103K00000X	Behavior Analyst	1-20-42599
2	103K00000X	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	:	1851742936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY MARIE BIERSACK BCBA

Provider Business Mailing Address
First Line	:	333 W 41ST ST STE 414
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3608
Country	:	US
Telephone Number	:	786-673-9355
Fax Number	:	407-588-6294

Provider Business Practice Location Address
First Line	:	5798 S SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4819
Country	:	US
Telephone Number	:	888-754-0398
Fax Number	:	954-866-5513

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

Provider Enumeration Date	:	06/29/2016
Last Update Date	:	04/09/2025

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