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NPI Code Detail

MEDICARE: EMELY LAGO

MEDICARE: EMELY LAGO
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 Technician

General Provider Information

NPI Number : 1164378790
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMELY LAGO
Provider Business Mailing Address
First Line : 2607 37TH ST SW
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33976-4556
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12811 KENWOOD LN STE 213
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-5648
Country : US
Telephone Number : 239-537-9646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “ EMELY LAGO ” Practice Location

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