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General NPI Number Information
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NPI Number | 1972081008
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Entity Type | Individual
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Provider Name | SAMEERAH MUTTAQI BCABA
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 8001 BEATY GROVE DR
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City | TAMPA
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State | FL
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Zip | 33626-1602
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Country | US
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Telephone | 813-926-5454
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Fax | 813-337-0937
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Provider Business Mailing Address
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Address Line | 10133 PINK PALMATA CT
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City | RIVERVIEW
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State | FL
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Zip | 33578-3626
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Country | US
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Telephone | 570-730-1238
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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 | 0-21-13206
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License Number State | FL
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