MEDICARE: NAHIL CARRANZA

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

General Provider Information

NPI Number	:	1205281664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAHIL CARRANZA

Provider Business Mailing Address
First Line	:	8951 SW 52ND PL
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-5125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8951 SW 52ND PL
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-5125
Country	:	US
Telephone Number	:	954-702-3105
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	05/03/2016

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Directions to “ NAHIL CARRANZA ” Practice Location

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