MEDICARE: CHEYLA L FERNANDEZ COCA BOAN BCABA

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	0-25-16712	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1083207302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYLA L FERNANDEZ COCA BOAN BCABA

Provider Business Mailing Address
First Line	:	6240 NW 173RD ST APT 1040
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-4562
Country	:	US
Telephone Number	:	786-805-7831
Fax Number	:

Provider Business Practice Location Address
First Line	:	8785 SW 165TH AVE STE 104
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-5827
Country	:	US
Telephone Number	:	786-206-6500
Fax Number	:

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

Provider Enumeration Date	:	02/17/2021
Last Update Date	:	12/15/2025

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