MEDICARE: MY EASY THERAPY CENTER LLC

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

General Provider Information

NPI Number	:	1306552856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY EASY THERAPY CENTER LLC

Provider Business Mailing Address
First Line	:	8414 MARGARITA DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-1227
Country	:	US
Telephone Number	:	407-963-9759
Fax Number	:

Provider Business Practice Location Address
First Line	:	8414 MARGARITA DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-1227
Country	:	US
Telephone Number	:	407-963-9759
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SONIA N ARVELO ORTA
Credential	:
Telephone Number	:	407-963-9759

Provider Enumeration Date	:	01/27/2023
Last Update Date	:	01/27/2023

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Directions to “MY EASY THERAPY CENTER LLC ” Practice Location

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