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NPI Code Detail

MEDICARE: LACOSTA THERAPY, LLC

MEDICARE: LACOSTA THERAPY, LLC
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 AnalystMH12872FL

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 : 1093224271
Entity Type Code : Organization
Provider Name (Legal Business Name) : LACOSTA THERAPY, LLC
Provider Business Mailing Address
First Line : 657 SOUTH DRIVE
Second Line : SUITE 403
City : MIAMI SPRINGS
State : FL
Zip : 33166
Country : US
Telephone Number : 786-860-5161
Fax Number :
Provider Business Practice Location Address
First Line : 657 SOUTH DR STE 403
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-5926
Country : US
Telephone Number : 786-860-5161
Fax Number :
Authorized Official
Title or Position : BCBA OWNER
Name : LISETTE LACOSTA
Credential : BCBA
Telephone Number : 786-860-5161
Provider Enumeration Date : 09/20/2017
Last Update Date : 04/17/2024

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Directions to “LACOSTA THERAPY, LLC ” Practice Location

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