MEDICARE: PRINCIPLES OF LEARNING 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	:	1396351870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCIPLES OF LEARNING INC

Provider Business Mailing Address
First Line	:	6361 PRESIDENTIAL CT # C-111
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6361 PRESIDENTIAL CT
Second Line	:	C-111
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3543
Country	:	US
Telephone Number	:	786-712-1556
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IDANIA TARRAU
Credential	:
Telephone Number	:	786-712-1556

Provider Enumeration Date	:	09/19/2020
Last Update Date	:	09/23/2020

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