Healthcare Provider Details

I. General information

NPI: 1104346105
Provider Name (Legal Business Name): ANDREA ROMINA SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 NE 192ND ST APT 1104
AVENTURA FL
33180-2456
US

IV. Provider business mailing address

3400 NE 192ND ST APT 1104
AVENTURA FL
33180-2456
US

V. Phone/Fax

Practice location:
  • Phone: 786-343-7142
  • Fax: 954-431-5144
Mailing address:
  • Phone: 786-343-7142
  • Fax: 954-431-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: