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General NPI Number Information
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NPI Number | 1124531769
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Entity Type | Individual
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Provider Name | KEISHLA M TORRES-MALDONADO BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 304 E PINE ST # 1252
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City | LAKELAND
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State | FL
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Zip | 33801-4969
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Country | US
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Telephone | 813-602-0068
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Fax | 813-354-2715
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Provider Business Mailing Address
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Address Line | 2424 W BRANDON BLVD # 1268
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City | BRANDON
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State | FL
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Zip | 33511-4717
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Country | US
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Telephone | 863-354-2715
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Fax | 813-354-2715
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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