Healthcare Provider Details

I. General information

NPI: 1720541113
Provider Name (Legal Business Name): PATRICIA PRESY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2154 CENTRAL FLORIDA PKWY STE B2
ORLANDO FL
32837-8986
US

IV. Provider business mailing address

23515 VALDERAMA LN
SORRENTO FL
32776-6937
US

V. Phone/Fax

Practice location:
  • Phone: 407-674-7670
  • Fax:
Mailing address:
  • Phone: 516-695-9333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-47794
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: