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NPI Code Detail

MEDICARE: SUWENDA LOUIS

MEDICARE:   SUWENDA  LOUIS
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
1390200000XStudent in an Organized Health Care Education/Training Program
2103K00000XBehavior Analyst1-18-30663FL

General Provider Information

NPI Number : 1154683159
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUWENDA LOUIS
Provider Business Mailing Address
First Line : 541 SW 63RD AVE
Second Line :
City : MARGATE
State : FL
Zip : 33068-1730
Country : US
Telephone Number : 754-214-9842
Fax Number : 954-577-7780
Provider Business Practice Location Address
First Line : 1239 E NEWPORT CENTER DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33442-7711
Country : US
Telephone Number : 754-444-3707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2012
Last Update Date : 06/17/2020

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Directions to “ SUWENDA LOUIS ” Practice Location

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