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NPI Code Detail

MEDICARE: ALECIA MARIE PADDOCK

MEDICARE: ALECIA MARIE PADDOCK
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 Analyst0-15-6864FL

General Provider Information

NPI Number : 1861826125
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALECIA MARIE PADDOCK
Provider Business Mailing Address
First Line : 107 ANTILLA AVE
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-3301
Country : US
Telephone Number : 305-567-5881
Fax Number : 305-567-5882
Provider Business Practice Location Address
First Line : 107 ANTILLA AVE
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-3301
Country : US
Telephone Number : 305-567-5881
Fax Number : 305-567-5882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2013
Last Update Date : 01/06/2016

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Directions to “ ALECIA MARIE PADDOCK ” Practice Location

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