Healthcare Provider Details

I. General information

NPI: 1689189722
Provider Name (Legal Business Name): ORIANA STOESSER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ORIANA GOMEZ

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 SW 99TH TER
PEMBROKE PINES FL
33025-1059
US

IV. Provider business mailing address

1302 MARCY CT
CLARKSVILLE TN
37042-8697
US

V. Phone/Fax

Practice location:
  • Phone: 904-557-0493
  • Fax:
Mailing address:
  • Phone: 904-557-0493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-85498
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: