MEDICARE: SARABIA J TILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4	372500000X	Chore Provider
5	372600000X	Adult Companion
6	3747A0650X	Attendant Care Provider
7	3747P1801X	Personal Care Attendant
8	385H00000X	Respite Care
9	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
10	385HR2065X	Child Physical Disabilities Respite Care
11	374U00000X	Home Health Aide
12	106E00000X	Assistant Behavior Analyst
13	106S00000X	Behavior Technician
14	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1326678442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARABIA J TILLER

Provider Business Mailing Address
First Line	:	1011 GRACE AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2494
Country	:	US
Telephone Number	:	850-625-8266
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 GRACE AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2494
Country	:	US
Telephone Number	:	850-625-8266
Fax Number	:

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

Provider Enumeration Date	:	01/16/2020
Last Update Date	:	01/16/2020

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Directions to “ SARABIA J TILLER ” Practice Location

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