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NPI Code Detail

MEDICARE: LISA RAYMOND

MEDICARE: LISA RAYMOND
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
1103K00000XBehavior Analyst12149010FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346661089
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA RAYMOND
Provider Business Mailing Address
First Line : 1311 W GOLFVIEW DR
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33026-3146
Country : US
Telephone Number : 888-880-9270
Fax Number :
Provider Business Practice Location Address
First Line : 2615 FAIRWAYS DR
Second Line :
City : HOMESTEAD
State : FL
Zip : 33035-1173
Country : US
Telephone Number : 540-632-8331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2013
Last Update Date : 06/08/2021

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Directions to “ LISA RAYMOND ” Practice Location

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