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NPI Code Detail

MEDICARE: SOPHIA GRACE TALIAFERRO

MEDICARE: SOPHIA GRACE TALIAFERRO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1407788904
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA GRACE TALIAFERRO
Provider Business Mailing Address
First Line : 131 41ST AVE N UNIT 15
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33703-4867
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5020 GUNN HWY STE 250
Second Line :
City : TAMPA
State : FL
Zip : 33624-6361
Country : US
Telephone Number : 844-244-1818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ SOPHIA GRACE TALIAFERRO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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