MEDICARE: LOURDES SEGUI

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1962267385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOURDES SEGUI

Provider Business Mailing Address
First Line	:	13275 WHITEHAVEN LN APT 304
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-1574
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13275 WHITEHAVEN LN APT 304
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-1574
Country	:	US
Telephone Number	:	315-345-1611
Fax Number	:

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

Provider Enumeration Date	:	02/15/2024
Last Update Date	:	03/06/2024

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Directions to “ LOURDES SEGUI ” Practice Location

Language	Start Address	Practice Location

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