MEDICARE: DANNA ALENCAR

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1194236877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNA ALENCAR

Provider Business Mailing Address
First Line	:	1928 VERNON PL
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-1643
Country	:	US
Telephone Number	:	386-290-9466
Fax Number	:

Provider Business Practice Location Address
First Line	:	1928 VERNON PL
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-1643
Country	:	US
Telephone Number	:	386-290-9466
Fax Number	:

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

Provider Enumeration Date	:	10/20/2017
Last Update Date	:	10/20/2017

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Directions to “ DANNA ALENCAR ” Practice Location

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