MEDICARE: NASHRA FREDERIC

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	106S00000X	Behavior Technician	F246383344000	FL

General Provider Information

NPI Number	:	1124971569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NASHRA FREDERIC

Provider Business Mailing Address
First Line	:	2251 ISLAND DR
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3503
Country	:	US
Telephone Number	:	305-967-3261
Fax Number	:

Provider Business Practice Location Address
First Line	:	2251 ISLAND DR
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3503
Country	:	US
Telephone Number	:	305-967-3261
Fax Number	:

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

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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