MEDICARE: JUAN F TORO 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	1-21-51908	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15399388	OTHER	FL	PROVIEW CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225709751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN F TORO BCBA

Provider Business Mailing Address
First Line	:	2332 GALIANO ST FL 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5402
Country	:	US
Telephone Number	:	305-209-9696
Fax Number	:	305-967-8451

Provider Business Practice Location Address
First Line	:	2332 GALIANO ST FL 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5402
Country	:	US
Telephone Number	:	305-209-9696
Fax Number	:	305-967-8451

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

Provider Enumeration Date	:	09/23/2021
Last Update Date	:	09/23/2021

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