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General NPI Number Information
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NPI Number | 1346740685
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Entity Type | Individual
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Provider Name | BIANCA GERZANICH
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Gender | Female
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 1117 E HALLANDALE BEACH BLVD STE 6
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4488
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Country | US
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Telephone | 954-458-5040
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 NW 154TH LN
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1663
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Country | US
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Telephone |
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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 | RBT-18-52515
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT23002
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License Number State | FL
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