Healthcare Provider Details

I. General information

NPI: 1851241996
Provider Name (Legal Business Name): STEPHANIE FERRIGNO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 E NEW HAVEN AVE STE 1
MELBOURNE FL
32901-4576
US

IV. Provider business mailing address

307 E NEW HAVEN AVE STE 1
MELBOURNE FL
32901-4576
US

V. Phone/Fax

Practice location:
  • Phone: 321-241-1170
  • Fax: 321-241-1171
Mailing address:
  • Phone: 321-241-1170
  • Fax: 321-241-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: