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General NPI Number Information
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NPI Number | 1548719958
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Entity Type | Individual
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Provider Name | MARIA ANGELES CEREIJO
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Gender | Female
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 06/02/2019
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Provider Practice Location Address
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Address Line | 1513 BLUE JAY CIR
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City | WESTON
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State | FL
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Zip | 33327-2011
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Country | US
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Telephone | 786-612-0857
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Fax |
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Provider Business Mailing Address
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Address Line | 1513 BLUE JAY CIR
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City | WESTON
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State | FL
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Zip | 33327-2011
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Country | US
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Telephone | 786-612-0898
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | C622-541-63-848-0
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | C622-541-63-848-0
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License Number State | FL
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