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NPI Code Detail

MEDICARE: ILEANA VIZCAINO

MEDICARE: ILEANA VIZCAINO
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 Technician

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 : 1023761566
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILEANA VIZCAINO
Provider Business Mailing Address
First Line : 10720 RHETT BUTLER ALY
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-1884
Country : US
Telephone Number : 407-234-5568
Fax Number :
Provider Business Practice Location Address
First Line : 4727 W IRLO BRONSON MEMORIAL HWY
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-5326
Country : US
Telephone Number : 321-972-4039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2022
Last Update Date : 02/15/2026

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Directions to “ ILEANA VIZCAINO ” Practice Location

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