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NPI Code Detail

MEDICARE: MISS BLAIR NICHOLE ORTMAN BCBA

MEDICARE:  MISS BLAIR NICHOLE ORTMAN  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
1103K00000XBehavior Analyst0-13-5479FL

Other Identifiers

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

General Provider Information

NPI Number : 1255772125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS BLAIR NICHOLE ORTMAN BCBA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 185-583-2672
Fax Number :
Provider Business Practice Location Address
First Line : 1413 TECH BLVD STE 122
Second Line :
City : TAMPA
State : FL
Zip : 33619-7822
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2013
Last Update Date : 05/27/2021

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Directions to “ MISS BLAIR NICHOLE ORTMAN BCBA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.