Healthcare Provider Details

I. General information

NPI: 1780421156
Provider Name (Legal Business Name): AHMED IGLESIAS MS, ED.S, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3632 LAND O LAKES BLVD
LAND O LAKES FL
34639-4405
US

IV. Provider business mailing address

3632 LAND O LAKES BLVD
LAND O LAKES FL
34639-4405
US

V. Phone/Fax

Practice location:
  • Phone: 813-507-7055
  • Fax:
Mailing address:
  • Phone: 813-507-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-78500
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: