MEDICARE: RHEA ISABEL TAGORA

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	103K00000X	Behavior Analyst	LBA1109	NV
2	106E00000X	Assistant Behavior Analyst	LABA448	NV

General Provider Information

NPI Number	:	1144784422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHEA ISABEL TAGORA

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 N BUFFALO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-4133
Country	:	US
Telephone Number	:	702-706-8732
Fax Number	:

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

Provider Enumeration Date	:	01/30/2019
Last Update Date	:	01/10/2026

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Directions to “ RHEA ISABEL TAGORA ” Practice Location

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