=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376922922
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA MORGADO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2015
-----------------------------------------------------
Last Update Date | 12/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5180 W ATLANTIC AVE STE 110
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-8103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-663-9599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 150 LAKEVIEW DR APT 204
-----------------------------------------------------
City | WESTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33326-2521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-663-9599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-22-63117
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------