Healthcare Provider Details

I. General information

NPI: 1336614395
Provider Name (Legal Business Name): PAULA ANDREA BUENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 10/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 W ATLANTIC AVE STE 114
DELRAY BEACH FL
33484-8103
US

IV. Provider business mailing address

340 CRESTWOOD CIR APT 208
ROYAL PALM BEACH FL
33411-4977
US

V. Phone/Fax

Practice location:
  • Phone: 561-926-2537
  • Fax: 561-200-5595
Mailing address:
  • Phone: 561-396-6199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: