MEDICARE: NAZIRA CEJAS BCBA

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	LABA10000940	MA
2	106S00000X	Behavior Technician
3	222Q00000X	Developmental Therapist
4	103K00000X	Behavior Analyst	1-20-45454	FL

General Provider Information

NPI Number	:	1164934980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAZIRA CEJAS BCBA

Provider Business Mailing Address
First Line	:	2019 NW 86TH WAY
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6180
Country	:	US
Telephone Number	:	786-624-1712
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 S LAKE DR
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-4626
Country	:	US
Telephone Number	:	561-460-7148
Fax Number	:

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

Provider Enumeration Date	:	11/02/2017
Last Update Date	:	05/21/2024

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