MEDICARE: H-EZ BEHAVIOR INC

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	:	1386214682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H-EZ BEHAVIOR INC

Provider Business Mailing Address
First Line	:	3418 HANDY RD STE 102
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4603
Country	:	US
Telephone Number	:	813-416-9745
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 HANDY RD STE 102
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4603
Country	:	US
Telephone Number	:	813-416-9745
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIMMY HERNANDEZ
Credential	:
Telephone Number	:	813-416-9745

Provider Enumeration Date	:	06/29/2021
Last Update Date	:	06/29/2021

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Directions to “H-EZ BEHAVIOR INC ” Practice Location

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