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NPI Code Detail

MEDICARE: CARMEN LAGO GUZMAN

MEDICARE: CARMEN LAGO GUZMAN
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
1106E00000XAssistant Behavior Analyst0-19-9660FL
2106S00000XBehavior TechnicianRBT-15-11565FL

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 : 1346798014
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN LAGO GUZMAN
Provider Business Mailing Address
First Line : 24331 SW 129TH CT
Second Line :
City : HOMESTEAD
State : FL
Zip : 33032-4013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5051 MEMORIAL HWY UNIT B
Second Line :
City : TAMPA
State : FL
Zip : 33634-7355
Country : US
Telephone Number : 786-395-8225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2016
Last Update Date : 03/11/2026

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Directions to “ CARMEN LAGO GUZMAN ” Practice Location

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