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NPI Code Detail

MEDICARE: QUINTON BUCKHANAN

MEDICARE: QUINTON BUCKHANAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician537153FL

General Provider Information

NPI Number : 1003458514
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUINTON BUCKHANAN
Provider Business Mailing Address
First Line : 3771 STEFANI RD
Second Line :
City : CANTONMENT
State : FL
Zip : 32533-7795
Country : US
Telephone Number : 850-607-6910
Fax Number : 850-607-6932
Provider Business Practice Location Address
First Line : 1981 LEWIS TURNER BLVD
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-1256
Country : US
Telephone Number : 850-607-6910
Fax Number : 850-607-6932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2019
Last Update Date : 10/16/2019

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Directions to “ QUINTON BUCKHANAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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