DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SAMANTHA LEE BRODERICK BCBA

MEDICARE: SAMANTHA LEE BRODERICK 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
1103K00000XBehavior Analyst1-16-23336FL

General Provider Information

NPI Number : 1932494754
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA LEE BRODERICK BCBA
Provider Business Mailing Address
First Line : 6820 SOUTHPOINT PKWY STE 9
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6277
Country : US
Telephone Number : 888-754-0398
Fax Number :
Provider Business Practice Location Address
First Line : 6820 SOUTHPOINT PKWY STE 9
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6277
Country : US
Telephone Number : 888-754-0398
Fax Number : 954-866-5513
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2011
Last Update Date : 02/03/2026

Similar Medicare Providers

1871449652 — TAI'ANAH A GRAHAM
Practice Location Address:
6820 SOUTHPOINT PKWY STE 6
JACKSONVILLE, FL
32216-6277
Practice Phone: 888-754-0398
Practice Fax:
1760702526 — MR. MICHAEL WILLIAM HERN
Practice Location Address:
6820 SOUTHPOINT PKWY STE 9
JACKSONVILLE, FL
32216-6277
Practice Phone: 888-754-0398
Practice Fax:
1265771257 — STEPHANIE WHITAKER BCBA
Practice Location Address:
6820 SOUTHPOINT PKWY STE 9
JACKSONVILLE, FL
32216-6277
Practice Phone: 888-754-0398
Practice Fax:
1811325202 — JESSICA MCGOWAN
Practice Location Address:
6820 SOUTHPOINT PKWY STE 9
JACKSONVILLE, FL
32216-6277
Practice Phone: 888-754-0398
Practice Fax:
1548654619 — OANA BHOSLE
Practice Location Address:
6820 SOUTHPOINT PKWY STE 9
JACKSONVILLE, FL
32216-6277
Practice Phone: 904-299-0049
Practice Fax:
1154848166 — MS. ARCHANA RAJAREDDY BCBA
Practice Location Address:
6820 SOUTHPOINT PKWY STE 9
JACKSONVILLE, FL
32216-6277
Practice Phone: 888-754-0398
Practice Fax:

Directions to “ SAMANTHA LEE BRODERICK BCBA” 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.