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General NPI Number Information
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NPI Number | 1144190836
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Entity Type | Individual
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Provider Name | LUCYLLE L PANTANASSE
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Gender | Female
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 8395 W OAKLAND PARK BLVD STE A
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City | SUNRISE
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State | FL
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Zip | 33351-7301
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Country | US
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Telephone | 561-818-1367
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Fax |
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Provider Business Mailing Address
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Address Line | 280 SIERRA DR APT B514
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City | MIAMI
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State | FL
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Zip | 33179-1423
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Country | US
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Telephone | 786-484-6613
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Fax |
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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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