MEDICARE: MRS. NATALIE ASTORGA

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	0-14-6217	FL
2	106E00000X	Assistant Behavior Analyst	0-14-6217	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12325284	OTHER	FL	CAQH PROVIDER ID

General Provider Information

NPI Number	:	1275804536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE ASTORGA

Provider Business Mailing Address
First Line	:	571 NW 59TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11420 N KENDALL DR STE 112
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1039
Country	:	US
Telephone Number	:	305-279-1999
Fax Number	:

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

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	04/23/2018

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Directions to “ MRS. NATALIE ASTORGA ” Practice Location

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