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General NPI Number Information
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NPI Number | 1962087247
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Entity Type | Individual
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Provider Name | GURPREET BIRK
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Gender | Male
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 5959 LAKE ELLENOR DR STE 100
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City | ORLANDO
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State | FL
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Zip | 32809-4633
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Country | US
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Telephone | 866-411-6619
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Fax |
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Provider Business Mailing Address
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Address Line | 7230 AZURE CIR APT 4410
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City | ORLANDO
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State | FL
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Zip | 32836-7131
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Country | US
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Telephone | 224-217-3828
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-60661
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License Number State | IL
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