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NPI Code Detail

MEDICARE: LINNZI MARKS MA, BCBA

MEDICARE: LINNZI MARKS MA, BCBA
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
1103K00000XBehavior Analyst1-19-36770

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023583325
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINNZI MARKS MA, BCBA
Provider Business Mailing Address
First Line : 3891 BOURBON ST
Second Line :
City : PORT ORANGE
State : FL
Zip : 32129-6031
Country : US
Telephone Number : 386-453-8397
Fax Number :
Provider Business Practice Location Address
First Line : 454 FORT FLORIDA RD
Second Line :
City : DEBARY
State : FL
Zip : 32713-9714
Country : US
Telephone Number : 386-562-0170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2018
Last Update Date : 01/09/2023

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