Healthcare Provider Details

I. General information

NPI: 1396235925
Provider Name (Legal Business Name): ISABELLE RUNGE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 METROCENTER BLVD STE 350
ORLANDO FL
32835-7642
US

IV. Provider business mailing address

4620 N SR7 SUITE 300
LAUDERDALE LAKES FL
33319
US

V. Phone/Fax

Practice location:
  • Phone: 877-685-2783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-67080
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: