Healthcare Provider Details

I. General information

NPI: 1083149934
Provider Name (Legal Business Name): STEPHANIE OROZCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17231 NW 57TH AVE
MIAMI GARDENS FL
33055-3924
US

IV. Provider business mailing address

17231 NW 57TH AVE
MIAMI GARDENS FL
33055-3924
US

V. Phone/Fax

Practice location:
  • Phone: 954-682-0437
  • Fax:
Mailing address:
  • Phone: 954-682-0437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-12-149756
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: