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NPI Code Detail

MEDICARE: ANNET ESTRADA BERNAL

MEDICARE:   ANNET  ESTRADA BERNAL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1962240580
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNET ESTRADA BERNAL
Provider Business Mailing Address
First Line : 704 SW 3RD TER FL 33991
Second Line :
City : CAPE CORAL
State : FL
Zip : 33991-1975
Country : US
Telephone Number : 305-807-2460
Fax Number :
Provider Business Practice Location Address
First Line : 704 SW 3RD TER FL 33991
Second Line :
City : CAPE CORAL
State : FL
Zip : 33991-1975
Country : US
Telephone Number : 305-807-2460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2024
Last Update Date : 07/17/2024

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Directions to “ ANNET ESTRADA BERNAL ” Practice Location

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