MEDICARE: STEPHANIE FALCON

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205534864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE FALCON

Provider Business Mailing Address
First Line	:	620 SW 10TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3863
Country	:	US
Telephone Number	:	786-447-6102
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 SW 10TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3863
Country	:	US
Telephone Number	:	786-447-6102
Fax Number	:

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

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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Directions to “ STEPHANIE FALCON ” Practice Location

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