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General NPI Number Information
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NPI Number | 1700683356
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Entity Type | Individual
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Provider Name | ISAIAH TELOT
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Gender | Male
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 3109 W DR MARTIN LUTHER KING JR BLVD
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City | TAMPA
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State | FL
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Zip | 33607-6260
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Country | US
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Telephone | 813-289-0760
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Fax |
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Provider Business Mailing Address
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Address Line | 1628 LADORA DR APT 105
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City | BRANDON
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State | FL
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Zip | 33511-1227
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Country | US
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Telephone | 863-605-1754
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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-25-415876
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License Number State | FL
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