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General NPI Number Information
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NPI Number | 1891353975
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Entity Type | Individual
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Provider Name | LUCIANA DA COSTA
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Gender | Female
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 1513 SW 2ND CT
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City | HOMESTEAD
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State | FL
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Zip | 33030-6675
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Country | US
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Telephone | 786-972-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 244 SW 23RD ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2539
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Country | US
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Telephone | 786-473-4327
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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-19-88703
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BACB438700
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License Number State | FL
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