MEDICARE: GLADYS ROSA NARANJO BCBA

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	1-14-17442

General Provider Information

NPI Number	:	1417347139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLADYS ROSA NARANJO BCBA

Provider Business Mailing Address
First Line	:	13538 VILLAGE PARK DR
Second Line	:	SUITE 145
City	:	ORLANDO
State	:	FL
Zip	:	32837-7698
Country	:	US
Telephone Number	:	407-703-2948
Fax Number	:	407-250-4833

Provider Business Practice Location Address
First Line	:	13538 VILLAGE PARK DR
Second Line	:	SUITE 145
City	:	ORLANDO
State	:	FL
Zip	:	32837-7698
Country	:	US
Telephone Number	:	407-703-2948
Fax Number	:	407-250-4833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2015
Last Update Date	:	01/09/2024

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