MEDICARE: DEESHANTAE MICHELLE FLORENCE

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
1	106E00000X	Assistant Behavior Analyst		FL

General Provider Information

NPI Number	:	1033057062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEESHANTAE MICHELLE FLORENCE

Provider Business Mailing Address
First Line	:	115 SW 9TH TER FL 33312
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1740
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 SW 9TH TER FL 33312
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1740
Country	:	US
Telephone Number	:	754-283-0373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ DEESHANTAE MICHELLE FLORENCE ” Practice Location

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