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NPI 1992374102

NPI 1992374102 : KLBAC, INC. : KEY LARGO, FL

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General NPI Number Information
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    NPI Number           |    1992374102
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    Entity Type          |    Organization 
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    Legal Business Name  |    KLBAC, INC. 
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Dates
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    Enumeration Date     |    06/22/2021
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    Last Update Date     |    06/30/2021
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Provider Practice Location Address
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    Address Line         |    263 SAINT THOMAS AVE 
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    City                 |    KEY LARGO
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    State                |    FL
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    Zip                  |    33037-4321
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    Country              |    US
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    Telephone            |    305-764-2070
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    263 SAINT THOMAS AVE 
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    City                 |    KEY LARGO
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    State                |    FL
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    Zip                  |    33037-4321
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    Country              |    US
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    Telephone            |    305-764-2070
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    Fax                  |    
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Authorized Official
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    Title or Position    |    BCBA
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    Name                 |     LIMAY PEREZ CHAVIANO 
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    Credential           |    
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    Telephone            |    305-764-2070
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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       |    
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    License Number State |    
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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       |    
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    License Number State |    
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