Healthcare Provider Details

I. General information

NPI: 1639455884
Provider Name (Legal Business Name): MS. TANIA LUMBRERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21301 POWERLINE RD STE 103
BOCA RATON FL
33433-2389
US

IV. Provider business mailing address

13724 HERO PATH
DELRAY BEACH FL
33484-1372
US

V. Phone/Fax

Practice location:
  • Phone: 561-235-5205
  • Fax:
Mailing address:
  • Phone: 954-534-5721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number25576
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: