MEDICARE: CLAUDIA REIGOSA

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	1-14-10190	TX

General Provider Information

NPI Number	:	1275827602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA REIGOSA

Provider Business Mailing Address
First Line	:	3161 S OCEAN DR APT 709
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-7278
Country	:	US
Telephone Number	:	786-359-6362
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 S OCEAN DR APT 709
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-7278
Country	:	US
Telephone Number	:	786-359-6362
Fax Number	:

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

Provider Enumeration Date	:	06/02/2011
Last Update Date	:	05/22/2020

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Directions to “ CLAUDIA REIGOSA ” Practice Location

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