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NPI Code Detail

MEDICARE: JACKLYN ARAQUE

MEDICARE: JACKLYN ARAQUE
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 TechnicianFL
2103K00000XBehavior AnalystFL

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 : 1134654585
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACKLYN ARAQUE
Provider Business Mailing Address
First Line : 362 LAWLER ST
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33954-3811
Country : US
Telephone Number : 941-457-6621
Fax Number :
Provider Business Practice Location Address
First Line : 362 LAWLER ST
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33954-3811
Country : US
Telephone Number : 941-457-6621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2017
Last Update Date : 02/28/2026

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Directions to “ JACKLYN ARAQUE ” Practice Location

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