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NPI 1316677065

NPI 1316677065 : ERIKA LAVERNIA : PEMBROKE PINES, FL

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General NPI Number Information
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    NPI Number           |    1316677065
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    Entity Type          |    Individual 
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    Provider Name        |    ERIKA LAVERNIA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/15/2022
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    Last Update Date     |    06/15/2022
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Provider Practice Location Address
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    Address Line         |    701 PROMENADE DR STE 250 
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    City                 |    PEMBROKE PINES
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    State                |    FL
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    Zip                  |    33026-6035
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    Country              |    US
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    Telephone            |    954-399-2637
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12904 NW 104TH AVE 
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    City                 |    HIALEAH GARDENS
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    State                |    FL
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    Zip                  |    33018-6045
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    Country              |    US
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    Telephone            |    786-238-4560
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    22217832
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    License Number State |    FL
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