Healthcare Provider Details

I. General information

NPI: 1548617335
Provider Name (Legal Business Name): BARBARA BEJARANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2016
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6438 SW 27TH ST
MIAMI FL
33155-2955
US

IV. Provider business mailing address

6438 SW 27TH ST
MIAMI FL
33155-2955
US

V. Phone/Fax

Practice location:
  • Phone: 305-586-6605
  • Fax:
Mailing address:
  • Phone: 305-586-6605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: