Healthcare Provider Details

I. General information

NPI: 1114512019
Provider Name (Legal Business Name): ANNA MARIE FIORE MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 DUNLAP AVE SE
PALM BAY FL
32909-3717
US

IV. Provider business mailing address

244 DUNLAP AVE SE
PALM BAY FL
32909-3717
US

V. Phone/Fax

Practice location:
  • Phone: 321-344-0302
  • Fax:
Mailing address:
  • Phone: 321-344-0302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-59073
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA1383
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002703
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-59073
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: