MEDICARE: MRS. NORMA PATRICIA BAVARESCO 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	1-20-46199	FL
2	106E00000X	Assistant Behavior Analyst	0-19-9826	FL

General Provider Information

NPI Number	:	1871155465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NORMA PATRICIA BAVARESCO BCBA

Provider Business Mailing Address
First Line	:	11025 W 33RD WAY
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-2196
Country	:	US
Telephone Number	:	786-280-0937
Fax Number	:

Provider Business Practice Location Address
First Line	:	11025 W 33RD WAY
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-2196
Country	:	US
Telephone Number	:	786-280-0937
Fax Number	:

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

Provider Enumeration Date	:	07/03/2019
Last Update Date	:	02/24/2026

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