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General NPI Number Information
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NPI Number | 1376416727
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Entity Type | Individual
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Provider Name | KIOSBI PENATE QUESADA
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Gender | Male
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 13911 N DALE MABRY HWY STE 108
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City | TAMPA
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State | FL
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Zip | 33618-2414
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Country | US
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Telephone | 813-784-3619
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Fax | 813-305-7033
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Provider Business Mailing Address
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Address Line | 6603 REEF CIR
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City | TAMPA
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State | FL
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Zip | 33625-6525
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Country | US
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Telephone | 813-516-1374
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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-25-474677
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License Number State | FL
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