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NPI Code Detail

MEDICARE: CAROLINA VIZCAINO RBT

MEDICARE:   CAROLINA  VIZCAINO  RBT
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1235795428
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINA VIZCAINO RBT
Provider Business Mailing Address
First Line : 6861 LIBERTY ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33024-3928
Country : US
Telephone Number : 786-908-3377
Fax Number :
Provider Business Practice Location Address
First Line : 1000 NW 65TH ST STE 201
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-1113
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2019
Last Update Date : 05/14/2019

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Directions to “ CAROLINA VIZCAINO RBT” Practice Location

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