Healthcare Provider Details

I. General information

NPI: 1699234492
Provider Name (Legal Business Name): HILARIO JOEL CIPRIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5798 S SEMORAN BLVD
ORLANDO FL
32822-4819
US

IV. Provider business mailing address

10600 BLOOMFIELD DR APT 1432
ORLANDO FL
32825-5911
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0398
  • Fax:
Mailing address:
  • Phone: 561-846-9302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB495597
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: