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NPI Code Detail

MEDICARE: ALEJANDRO ABREU JR.

MEDICARE: ALEJANDRO ABREU JR.
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 : 1306456132
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEJANDRO ABREU JR.
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5035
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 124 CAPULET DR STE 102
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32092-4538
Country : US
Telephone Number : 904-429-4416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2020
Last Update Date : 08/06/2020

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